Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Eur J Neurol. 2018 Nov;25(11):1352-1357. doi: 10.1111/ene.13733. Epub 2018 Jul 26.
The non-fluent/agrammatic variant of primary progressive aphasia (agPPA) is a heterogeneous diagnosis wherein some individuals have apraxia of speech (AOS). When agPPA includes AOS, a tauopathy is the likely underlying pathology. Recently, [18F]AV-1451 was developed for the in-vivo assessment of tau. In this study, we compared patterns of tau tracer uptake in patients with agPPA with and without AOS.
Nine patients with agPPA (four without AOS) underwent tau positron emission tomography imaging with [18F]AV-1451. Uptake of [18F]AV-1451 was assessed as cortical to cerebellar crus ratio (standard uptake value ratio) in cortical regions of interest measured using the MCALT atlas and compared voxel-wise in SPM12. Each patient was age- and sex-matched to three controls.
The agPPA without AOS showed uptake in the left frontal and temporal lobes, whereas agPPA with AOS showed uptake in the bilateral supplementary motor areas, frontal lobes, precuneus and precentral gyrus relative to controls. The left precentral gyrus had uptake in agPPA with AOS relative to those without AOS.
This cross-sectional study suggests that [18F]AV-1451 uptake in the precentral gyrus is implicated in AOS in agPPA.
原发性进行性失语(agPPA)的非流利/语法障碍型是一种异质性诊断,其中一些个体存在言语失用症(AOS)。当 agPPA 包含 AOS 时,很可能是tau 病导致的。最近,[18F]AV-1451 被开发用于 tau 的体内评估。在这项研究中,我们比较了伴有和不伴有 AOS 的 agPPA 患者的 tau 示踪剂摄取模式。
9 名 agPPA 患者(4 名无 AOS)接受了[18F]AV-1451 的 tau 正电子发射断层扫描成像。使用 MCALT 图谱测量皮质感兴趣区的皮质与小脑后脚比(标准摄取值比)来评估[18F]AV-1451 的摄取,并在 SPM12 中进行体素比较。每个患者都与三个对照组进行年龄和性别匹配。
无 AOS 的 agPPA 显示左额叶和颞叶摄取,而有 AOS 的 agPPA 显示双侧辅助运动区、额叶、楔前叶和中央前回摄取增加,相对于对照组。在 agPPA 伴有 AOS 时,左侧中央前回的摄取量多于无 AOS 的 agPPA。
这项横断面研究表明,中央前回的[18F]AV-1451 摄取与 agPPA 中的 AOS 有关。