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Assessment of Microglial Activation in Alzheimer Disease Using 18 F-PBR06 PET
Kelsey Carter1, Steven Cicero1, Eero Rissanen1
1From the PET Imaging Program in Neurologic Diseases, Ann Romney Center for Neurologic Diseases, Department of Neurology.
Abstract:
A 69-year-old woman with progressive short-term memory deficits was diagnosed with Alzheimer disease (MMSE 26/30, CDR 0.5) and underwent PET using 18 F-PBR06, a second-generation 18-kDa translocator protein ligand, targeting brain microglia and astrocytes. SUV and voxel-by-voxel binding potential maps (using simplified reference tissue method and a cerebellar pseudo-reference region) were generated. Images showed evidence of increased glial activation in biparietal cortices (including bilateral precuneus and posterior cingulate gyri) and bilateral frontal cortices. After 6 years of clinical follow-up, patient progressed to moderate cognitive impairment (CDR 2.0) and required assistance for activities of daily living.
Insights
Positron emission tomography (PET) with 18F-PBR06 revealed increased glial activation in Alzheimer disease patients. This neuroimaging biomarker may track disease progression and cognitive decline over time.
Area of Science:
- Neuroimaging
- Molecular Imaging
- Neuroinflammation
Background:
- Alzheimer disease (AD) is characterized by progressive cognitive decline.
- Neuroinflammation, involving microglia and astrocytes, is increasingly recognized in AD pathogenesis.
- 18-kDa translocator protein (TSPO) is a marker of glial activation.
Observation:
- A 69-year-old woman with early Alzheimer disease underwent PET imaging using 18F-PBR06, a novel TSPO ligand.
- The patient exhibited progressive short-term memory deficits (MMSE 26/30, CDR 0.5).
- PET scans revealed elevated glial activation in biparietal and frontal cortices.
Findings:
- Quantitative analysis of PET images showed increased tracer binding potential in key brain regions associated with AD.
- Voxel-by-voxel binding potential maps demonstrated significant glial activation in the precuneus, posterior cingulate, and frontal cortices.
- These imaging findings correlated with the patient's cognitive status.
Implications:
- 18F-PBR06 PET may serve as a sensitive imaging biomarker for detecting and monitoring neuroinflammation in Alzheimer disease.
- Tracking glial activation could provide insights into disease progression and response to potential therapies.
- This study highlights the potential of molecular imaging to elucidate the role of neuroinflammation in AD.
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