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Amyloid and FDG-PET study of logopenic primary progressive aphasia: evidence for the existence of two subtypes

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Abstract

The logopenic variant of primary progressive aphasia (lvPPA) has been associated with Alzheimer disease, although this relationship is still subject to debate. The purpose of this study is to determine the frequency of amyloid biomarkers in patients with lvPPA, and record any potential clinical or topographic differences between patients with and without amyloid deposits. We conducted cognitive examination and positron-emission tomography studies with fluorodeoxyglucose (18F) and florbetapir (18F) in a cohort of 16 patients diagnosed with lvPPA. We evaluated the prevalence of amyloid deposits as well as any clinical and metabolic differences between the groups with and without significant presence of amyloid deposits. Eleven patients (69 %) were considered amyloid-positive. The amyloid-positive group displayed less metabolic activity in the left temporoparietal region than the control group, while the amyloid-negative group showed lower metabolism in the left temporoparietal region extending to the anterior temporal and basal frontal regions. The percentage of change in patients with clinical and FDG-PET follow-up did not differ between the amyloid-positive and amyloid-negative subgroups. The frequency of amyloid-positive cases confirms that lvPPA is frequently associated with Alzheimer disease. Amyloid-negative patients show a different cerebral metabolic pattern. These findings show the relevance of using amyloid PET to study lvPPA, and also suggest that the logopenic variant may not be specific to Alzheimer disease in certain cases.

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Acknowledgments

The authors would like to thank Spanish Society of Neurology’s Research Operations Office staff for their help in preparing this manuscript.

Conflicts of interest

The authors have no conflicts of interest to declare.

Ethical standard

The study was approved by the research committee at our hospital and conducted in accordance with the 1964 Helsinki Declaration and its later amendments.

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Authors and Affiliations

  1. Department of Neurology, Hospital Clínico San Carlos, San Carlos Institute for Health Research (IdISSC), Complutense University of Madrid, Calle Profesor Martín Lagos, S/N, 28040, Madrid, Spain

    Jordi A. Matías-Guiu, Teresa Moreno-Ramos, María Valles-Salgado, Marta Fernandez-Matarrubia & Jorge Matías-Guiu

  2. Department of Nuclear Medicine, Hospital Clínico San Carlos, San Carlos Institute for Health Research (IdISSC), Complutense University of Madrid, Calle Profesor Martín Lagos, S/N, 28040, Madrid, Spain

    María Nieves Cabrera-Martín & José Luis Carreras

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  1. Jordi A. Matías-Guiu
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  7. Jorge Matías-Guiu
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Correspondence to Jordi A. Matías-Guiu.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

415_2015_7738_MOESM1_ESM.pptx

Fig. 1. Cortical regions of interest used for analysis of the uptake florbetapir (18F). Numbers represent z-coordinates. (PPTX 1004 kb)

415_2015_7738_MOESM2_ESM.pdf

Table 1 Cortico-cerebellar standardized uptake value ratios for florbetapir (18F). (PDF 56 kb)

415_2015_7738_MOESM3_ESM.pdf

Table 2 Voxel-based analysis results. Coordinates and statistical data from the following analyses of brain metabolism: 1) lvPPA < healthy controls; 2) amyloid-positive lvPPA < healthy controls; 3) amyloid-negative lvPPA < healthy controls; 4) amyloid-positive lvPPA < amyloid-negative lvPPA; 5) amyloid-negative lvPPA < amyloid-positive lvPPA. (PDF 79 kb)

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Matías-Guiu, J.A., Cabrera-Martín, M.N., Moreno-Ramos, T. et al. Amyloid and FDG-PET study of logopenic primary progressive aphasia: evidence for the existence of two subtypes. J Neurol 262, 1463–1472 (2015). https://doi.org/10.1007/s00415-015-7738-z

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  • DOI: https://doi.org/10.1007/s00415-015-7738-z

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