Cited by 121Cerebrospinal fluid and hydrocephalusDementia and Cognitive Impairment ResearchAlzheimer's disease research and treatments

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Dynamic 11 C-PiB PET Shows Cerebrospinal Fluid Flow Alterations in Alzheimer Disease and Multiple Sclerosis

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Schubert, Julia J., Veronese, Mattia, Marchitelli, Livia, Bodini, Benedetta, Tonietto, Matteo, Stankoff, Bruno, Brooks, David J., Bertoldo, Alessandra, Edison, Paul, Turkheimer, Federico E.·2019·Journal of Nuclear Medicine

DOI 10.2967/jnumed.118.223834PMC PMC6785797

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Abstract

Cerebrospinal fluid (CSF) plays an important role in solute clearance and maintenance of brain homeostasis. 11C-Pittsburgh compound B (PiB) PET was recently proposed as a tool for detection of CSF clearance alterations in Alzheimer disease. The current study investigates the magnitude of 11C-PiB PET signal in the lateral ventricles of an independent group of Alzheimer and mild cognitive impairment subjects. We have also evaluated multiple sclerosis as a model of disease with CSF clearance alterations without amyloid-β tissue accumulation. Methods: A set of 11 Alzheimer and 12 mild cognitive impairment subjects and a set of 20 multiple sclerosis subjects with matched controls underwent MRI and dynamic 11C-PiB PET. Lateral ventricle regions of interest were generated manually from MRI data. PET data were analyzed using cerebellum or a supervised reference region for the Alzheimer and multiple sclerosis data sets, respectively. The magnitude of 11C-PiB signal in the lateral ventricles was calculated as area under the curve from 35 to 80 min and SUV ratio (SUVR) from 50 to 70 min. Compartmental modeling analysis was performed on a separate data set containing 11 Alzheimer and matched control subjects; this analysis included an arterial input function, to further understand the kinetics of the lateral ventricular 11C-PiB signal. Results: ANOVA revealed significant group differences in lateral ventricular SUVR across the Alzheimer, mild cognitive impairment, and healthy control groups (P = 0.004). Pairwise comparisons revealed significantly lower lateral ventricular SUVR in Alzheimer subjects than in healthy controls (P < 0.001) or mild cognitive impairment subjects (P = 0.029). Lateral ventricular SUVR was significantly lower in multiple sclerosis subjects than in healthy controls (P = 0.008). Compartmental modeling analysis revealed significantly lower uptake rates of 11C-PiB signal from blood (P = 0.005) and brain tissue (P = 0.004) to the lateral ventricles and significantly lower 11C-PiB signal clearance out of the lateral ventricles (P = 0.002) in Alzheimer subjects than in healthy controls. Conclusion: These results indicate that dynamic 11C-PiB PET can be used to observe pathologic changes in CSF dynamics. We have replicated previous work demonstrating CSF clearance deficits in Alzheimer disease associated with amyloid-β deposits and have extended the observations to include ventricular CSF clearance deficits in mild cognitive impairment and multiple sclerosis.

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Authors: Schubert, J. J., Veronese, M., Marchitelli, L., Bodini, B., Tonietto, M., Stankoff, B., Brooks, D. J., Bertoldo, A., Edison, P., & Turkheimer, F. E.
Affiliations: King's College London (GB)
Institut des Sciences Moléculaires (FR)
Imperial College London (GB)
University of Padua (IT)
ORCID: Schubert, Julia J.
Veronese, Mattia
Marchitelli, Livia
Bodini, Benedetta
Stankoff, Bruno
Brooks, David J.
Bertoldo, Alessandra
Edison, Paul
Turkheimer, Federico E.
Venue: Journal of Nuclear Medicine
Publisher: Society of Nuclear Medicine
Published: 2019-03-08
Volume: 60
Issue: 10
Pages: 1452-1460
ISSN: 0161-5505 (ISSN-L)
2159-662X
DOI: 10.2967/jnumed.118.223834
PMC: PMC6785797
OpenAlex: W2903977272
Cited by: 121
References: 79
Citations by year: 2026: 12 · 2025: 28 · 2024: 21 · 2023: 13 · 2022: 19 · 2021: 16 · 2020: 11 · 2019: 1
FWCI: 5.58
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Nuclear Medicine (publishedVersion)
bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Padua Research Archive (University of Padova) (submittedVersion)
HAL (submittedVersion)
Spiral (Imperial College London) (submittedVersion)
Funders: Eli Lilly and Company
Pfizer
GlaxoSmithKline
Fondation pour l'Aide à la Recherche sur la Sclérose en Plaques
European Committee for Treatment and Research in Multiple Sclerosis
National Institute for Health and Care Research
Agence Nationale de la Recherche (ANR-10-IAHU-0006)
Institut National de la Santé et de la Recherche Médicale
Novo Nordisk
Commissariat à l'Énergie Atomique et aux Énergies Alternatives
Association Européenne contre les Leucodystrophies
Medical Research Council
Direction de l’hospitalisation et de l’offre de Soins
Topics: Health Sciences › Medicine › Clinical Neurology › Cerebrospinal fluid and hydrocephalus
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
Keywords: [11C]PIB, Pittsburgh compound B, cerebrospinal fluid flow, cerebrospinal fluid clearance, Alzheimer's disease, multiple sclerosis, mild cognitive impairment, lateral ventricle, amyloid-beta, compartmental modeling, dynamic PET, cerebrospinal fluid dynamics, blood-brain barrier permeability, arterial input function, standardized uptake value ratio
MeSH terms: Adult, Aged, Algorithms, Alzheimer Disease, Aniline Compounds, Brain, Cerebrospinal Fluid, Female, Homeostasis, Humans, Kinetics, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Thiazoles, Reproducibility of Results, Case-Control Studies, Databases, Factual, Radiopharmaceuticals, Area Under Curve, Positron-Emission Tomography, Cognitive Dysfunction

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Dynamic 11 C-PiB PET Shows Cerebrospinal Fluid Flow Alterations in Alzheimer Disease and Multiple Sclerosis

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