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Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
Published on: January 28, 2014
Biomarkers
Rafael Angel Villino-Rodríguez1, Mario Riverol2, Fernando Minguez3
1University Clinica of Navarra, Pamplona, Navarra, Spain.
Background:
To describe the incidence of medial temporal hypometabolism as a pattern suggestive of LATE in patients with MCI, along with clinical characteristics, amyloid burden, and conversion to AD dementia.
Method:
We studied 207 MCI patients (mean age 72±6.1; MMSE 27±2.6; 50.8% male) who underwent FDG-PET and amyloid PET imaging, with follow-up over 24±17.5 months. FDG-PET patterns were classified as LATE-like (medial temporal), AD, and mixed (AD-LATE). Differences among these patterns were analyzed using SPM12, comparing to healthy controls. Amyloid PET was classified visually and quantified using the Centiloid scale. Statistical tests (Chi-square, ANOVA, and Cox regression) were applied to assess clinical features, amyloid burden, and AD dementia conversion rates.
Result:
LATE-like patterns were identified in 22 patients (10.6%), AD patterns in 57 (27.5%), and mixed patterns in 21 (10.1%). The remaining 107 patients (51.7%) with non-AD patterns were excluded. The LATE-like group showed prominent medial temporal hypometabolism, while posterior cingulate and parietotemporal hypometabolism were predominant in AD and mixed groups. LATE-like patients had higher MMSE scores, lower amyloid positivity, and lower Centiloid values compared to AD and mixed groups. Conversion to AD dementia was slower in LATE-like patients compared to AD (p = 0.005; HR=0.26 [0.1-0.67]) and mixed (p = 0.02; HR=0.29 [0.11-0.83]).
Conclusion:
The LATE-like FDG-PET pattern is not uncommon in MCI. It is linked to better cognitive performance, lower amyloid burden, and slower progression to AD dementia compared to AD and mixed patterns.
Insights
A specific brain metabolism pattern, LATE-like (medial temporal hypometabolism), is common in mild cognitive impairment (MCI). This pattern indicates slower progression to Alzheimer's dementia compared to typical AD patterns.
Area of Science:
- Neurology
- Neuroimaging
- Gerontology
Background:
- Medial temporal hypometabolism on FDG-PET suggests Limbic-predominant Age-related TDP-43 Encephalopathy (LATE).
- Understanding LATE's incidence and characteristics in Mild Cognitive Impairment (MCI) is crucial for differential diagnosis.
- This study investigates LATE-like patterns in MCI patients, comparing them with Alzheimer's Disease (AD) and mixed patterns.
Purpose of the Study:
- To determine the incidence of LATE-like patterns in MCI patients using FDG-PET.
- To characterize clinical features, amyloid burden, and cognitive decline in MCI patients with LATE-like patterns.
- To compare the rate of conversion to AD dementia among different FDG-PET patterns.
Main Methods:
- 207 MCI patients underwent FDG-PET and amyloid PET imaging with clinical follow-up.
- FDG-PET scans were classified into LATE-like, AD, and mixed patterns.
- Statistical analyses compared clinical data, amyloid burden (Centiloid scale), and conversion rates to AD dementia.
Main Results:
- LATE-like patterns were identified in 10.6% of MCI patients.
- LATE-like patients exhibited higher MMSE scores, lower amyloid positivity, and lower Centiloid values.
- Conversion to AD dementia was significantly slower in the LATE-like group compared to AD and mixed groups.
Conclusions:
- The LATE-like FDG-PET pattern is a notable finding in MCI, present in over 10% of cases.
- This pattern is associated with preserved cognitive function, reduced amyloid burden, and a slower disease trajectory.
- Distinguishing LATE-like patterns is vital for accurate prognosis and management of MCI patients.
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