Amyloid pet in primary progressive aphasia: case series and systematic review of the literature.
Primary progressive aphasia (PPA) is considered a heterogeneous syndrome, with different clinical subtypes and neuropathological causes. Novel PET biomarkers may help to predict the underlying neuropathology, but many aspects remain unclear. We studied the relationship between amyloid PET and PPA variant in a clinical series of PPA patients. A systematic review of the literature was performed. Patients with PPA were assessed over a 2-year period and classified based on language testing and the International Consensus Criteria as non-fluent/agrammatic (nfvPPA), semantic (svPPA), logopenic variant (lvPPA) or as unclassifiable (ucPPA). All patients underwent a Florbetapir (18-F) PET scan and images were analysed by two nuclear medicine physicians, using a previously validated reading method. Relevant studies published between January 2004 and January 2016 were identified by searching Medline and Web of Science databases. Twenty-four PPA patients were included (13 women, mean age 68.8, SD 8.3 years; range 54-83). Overall, 13/24 were amyloid positive: 0/2 (0%) nfvPPA, 0/4 (0%) svPPA, 10/14 (71.4%) lvPPA and 3/4 (75%) ucPPA (p = 0.028). The systematic review identified seven relevant studies, six including all PPA variants and one only lvPPA. Pooling all studies together, amyloid PET positivity was 122/224 (54.5%) for PPA, 14/52 (26.9%) for nfvPPA, 6/47 (12.8%) for svPPA, 101/119 for lvPPA (84.9%) and 12/22 (54.5%) for ucPPA. Amyloid PET may help to identify the underlying neuropathology in PPA. It could be especially useful in ucPPA, because in these cases it is more difficult to predict pathology. ucPPA is frequently associated with amyloid pathology.
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain. avgalende@yahoo.es.|Imas12. CIBERNED, Madrid, Spain. avgalende@yahoo.es.|Universidad Complutense de Madrid, Madrid, Spain. avgalende@yahoo.es.
Alberto
http://orcid.org/0000-0002-6834-7620
A
Villarejo-Galende
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain.|Imas12. CIBERNED, Madrid, Spain.
Sara
S
Llamas-Velasco
Department of Nuclear Medicine, Hospital Universitario Doce de Octubre, Madrid, Spain.
Adolfo
A
Gómez-Grande
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain.|Imas12. CIBERNED, Madrid, Spain.
Verónica
V
Puertas-Martín
Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain.
Israel
I
Contador
Department of Nuclear Medicine, Hospital Universitario Doce de Octubre, Madrid, Spain.
Pilar
P
Sarandeses
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain.|Imas12. CIBERNED, Madrid, Spain.
Marta
M
González-Sánchez
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain.|Imas12. CIBERNED, Madrid, Spain.
Rocío
R
Trincado
Department of Nuclear Medicine, Hospital Universitario Doce de Octubre, Madrid, Spain.
Patrick
P
Pilkington
Department of Nuclear Medicine, Hospital Universitario Doce de Octubre, Madrid, Spain.
Sebastián
S
Ruiz-Solis
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain.|Imas12. CIBERNED, Madrid, Spain.|Universidad Complutense de Madrid, Madrid, Spain.
David A
DA
Pérez-Martínez
Department of Neurology, Hospital Universitario Doce de Octubre, C/Andalucía, Km 5,4, E-28041, Madrid, Spain.|Imas12. CIBERNED, Madrid, Spain.
Alejandro
A
Herrero-San Martín
D000368:Aged; D000682:Amyloid / Q000378:metabolism*; D018888:Aphasia, Primary Progressive / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography
D000682:Amyloid
Amyloid; Florbetapir; PET; PIB; Primary progressive aphasia