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Amyloid PET findings in multiple sclerosis are associated with cognitive decline at 18 months
Vanesa Pytel1, Jordi A Matias-Guiu1, Jorge Matías-Guiu1
1Department of Neurology, Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC) Complutense University of Madrid. Calle Prof. Martín Lagos s/n. 28040. Madrid, Spain.
Objective:
To study the clinical, cognitive, and radiological progression of a cohort of patients with MS, taking into account the amyloid PET with 18F-florbetaben analyses.
Methods:
Twenty-nine patients with MS were assessed with longitudinal structural MRI and a clinical and comprehensive neuropsychological protocol, with a mean interval between assessments of 18 ± 3.31 months. 18F-florbetaben PET was performed at baseline. Uptake was analysed in demyelinating plaques (DWM) and normal-appearing white matter (NAWM). Results were correlated with clinical, cognitive and MRI data.
Results:
Patients with cognitive decline over the follow-up period showed a lower standardised uptake value ratio in NAWM and lower thalamic volume and a higher lesion load in the baseline MRI. Myelin status was correlated with EDSS and cognitive tests mainly evaluating visuospatial function and working memory. Lower uptake in NAWM at baseline was also associated with a growth in white matter lesion volume over time.
Conclusions:
Lower white matter uptake in amyloid PET is associated with cognitive decline and an increase in white matter lesion volume during the follow-up. Our study suggests that 18F-florbetaben may be a useful biomarker in assessing myelin status in MS, understanding MS pathophysiology, and predicting cognitive outcomes.
Insights
Amyloid PET imaging with 18F-florbetaben reveals that lower white matter uptake in patients with multiple sclerosis (MS) correlates with cognitive decline and increased lesion volume over time, suggesting its potential as a biomarker.
Area of Science:
- Neuroimaging
- Neurology
- Biomarker Discovery
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Cognitive impairment is a significant challenge in MS patients, impacting quality of life.
- Current biomarkers for MS progression and cognitive decline are limited.
Purpose of the Study:
- To investigate the relationship between amyloid PET imaging using 18F-florbetaben and the clinical, cognitive, and radiological progression in MS patients.
- To assess the utility of 18F-florbetaben PET in evaluating myelin status and predicting cognitive outcomes in MS.
Main Methods:
- A cohort of 29 MS patients underwent longitudinal structural MRI, clinical assessments, and comprehensive neuropsychological testing over approximately 18 months.
- 18F-florbetaben PET scans were performed at baseline, with uptake analyzed in demyelinating plaques (DWM) and normal-appearing white matter (NAWM).
- Correlations were established between PET data, clinical outcomes (EDSS), cognitive test results, and MRI-derived measures (thalamic volume, lesion load).
Main Results:
- Lower standardized uptake value ratios in normal-appearing white matter (NAWM) and reduced thalamic volume at baseline were associated with cognitive decline.
- Higher baseline lesion load and lower NAWM uptake on 18F-florbetaben PET correlated with cognitive decline and increased white matter lesion volume over time.
- Myelin status, as indicated by PET uptake, showed correlations with EDSS scores and cognitive functions, particularly visuospatial and working memory.
Conclusions:
- Reduced white matter 18F-florbetaben uptake in MS patients is linked to cognitive decline and disease progression.
- 18F-florbetaben PET may serve as a valuable biomarker for assessing myelin integrity in MS.
- This imaging technique shows promise for understanding MS pathophysiology and predicting cognitive trajectories in affected individuals.
