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Alzheimer's Imaging Consortium.

Nobuyuki Okamura1,2, Aiko Ishiki1, Kotaro Hiraoka2

  • 1Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.

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|December 23, 2025
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Summary
This summary is machine-generated.

[18F]SMBT-1 PET imaging reveals increased reactive astrogliosis in Alzheimer's disease (AD) and mild cognitive impairment (MCI) patients. This PET tracer shows potential as a biomarker for AD-related brain changes and correlates with plasma GFAP levels.

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Area of Science:

  • Neuroimaging
  • Biomarker Discovery
  • Alzheimer's Disease Research

Background:

  • Reactive astrogliosis is a hallmark of Alzheimer's disease (AD) pathology.
  • Monoamine oxidase B (MAO-B) is a target for visualizing reactive astrocytes.
  • [18F]SMBT-1 is a novel positron emission tomography (PET) tracer developed to target MAO-B.

Purpose of the Study:

  • To investigate the binding of [18F]SMBT-1 in the brains of patients with AD and mild cognitive impairment (MCI).
  • To assess the association between [18F]SMBT-1 binding and plasma biomarkers of neurodegeneration.
  • To evaluate the utility of [18F]SMBT-1 PET as a biomarker for reactive astrogliosis in AD.

Main Methods:

  • PET scans using [18F]SMBT-1 were performed on 35 healthy elderly controls (HCs), 44 MCI patients, and 13 AD patients.
  • Amyloid-beta (Aβ) pathology was confirmed using PiB PET or flutemetamol PET.
  • Plasma biomarkers (GFAP, pTau-217, NfL) were measured in a subset of participants.

Main Results:

  • Significantly increased [18F]SMBT-1 accumulation was observed in amyloid-positive MCI and AD patients compared to amyloid-negative HCs and MCI.
  • Elevated tracer binding occurred in brain regions characteristic of reactive astrogliosis and Aβ accumulation in AD.
  • Plasma GFAP levels were elevated in MCI and AD patients with increased neocortical [18F]SMBT-1 binding.

Conclusions:

  • [18F]SMBT-1 binding in the neocortex is elevated in MCI and AD patients, correlating with Aβ accumulation.
  • The findings align with elevated plasma GFAP measurements, supporting the biomarker potential of [18F]SMBT-1.
  • [18F]SMBT-1 PET imaging shows promise as a valuable tool for assessing reactive astrogliosis in the AD continuum.