Restricted accessBrief reportFirst published online 2021-08-17
The Combination of Metabolic Posterior Cingulate Cortical Abnormalities and Structural Asymmetries Improves the Differential Diagnosis Between Primary Progressive Aphasia and Alzheimer’s Disease
Differential diagnosis between primary progressive aphasia (PPA) and Alzheimer’s disease (AD) could be difficult if based on clinical grounds alone. We evaluated the combination of proton MR spectroscopy of posterior cingulate cortex (PCC) and quantitative structural imaging asymmetries to differentiate PPA from AD patients. A greater left-lateralized temporo-parietal atrophy (higher accuracy for the PCC, 81.4%) and metabolic neurodegenerative changes in PCC (accuracy 76.8%) was demonstrated in PPA versus AD. The combined multiparametric approach increased the accuracy to 94%in the differential diagnosis between these two neurodegenerative diseases.
MesulamMM (2001) Primary progressive aphasia. Ann Neurol49, 425–432.
2.
MesulamMMMGrossmanM, HillisA, KerteszA, WeintraubS (2003) The core and halo of primary progressive aphasia and semantic dementia. Ann Neurol54, S11–S14.
3.
SzatloczkiG, HoffmannI, VinczeV, KalmanJ, PakaskiM (2015) Speaking in Alzheimer’s disease, is that an early sign? The importance of changes in language abilities in Alzheimer’s disease. Front Aging Neurosci7, 195.
4.
HarrisJM, GallC, ThompsonJC, RichardsonAM, NearyD, du PlessisD, PalP, MannDM, SnowdenJS, JonesM (2013) Classification and pathology of primary progressive aphasia. Neurology81, 1832–1839.
MitoloM, Stanzani-MaseratiM, CapellariS, TestaC, RucciP, PodaR, OppiF, GallassiR, SambatiL, RizzoG, ParchiP, EvangelistiS, TalozziL, TononC, LodiR, LiguoriR (2019) Predicting conversion from mild cognitive impairment to Alzheimer’s disease using brain 1H-MRS and volumetric changes: A two-year retrospective follow-up study. Neuroimage Clin23, 101843.
13.
WaragaiM, MoriyaM, NojoT (2017) Decreased N-acetyl aspartate/myo-inositol ratio in the posterior cingulate cortex shown by magnetic resonance spectroscopy may be one of the risk markers of preclinical Alzheimer’s disease: A 7-year follow-up study. J Alzheimers Dis60, 1411–1427.
14.
KantarciK, WeigandSD, PrzybelskiSA, PreboskeGM, PankratzVS, VemuriP, SenjemML, MurphyMC, GunterJL, MachuldaMM, IvnikRJ, RobertsRO, BoeveBF, RoccaWA, KnopmanDS, PetersenRC, JackCRJr (2013) MRI and MRS predictors of mild cognitive impairment in a population-based sample. Neurology81, 126–133.
15.
CataniM, PiccirilliM, CherubiniA, TarducciR, SciarmaT, GobbiG, PelliccioliG, PetrilloSM, SeninU, MecocciP (2003) Axonal injury within language network in primary progressive aphasia. Ann Neurol53, 242–247.
16.
MaulS, GieglingI, RujescuD (2020) Proton magnetic resonance spectroscopy in common dementias-current status and perspectives. Front Psychiatry11, 769.
17.
McKhannGM, KnopmanDS, ChertkowH, HymanBT, JackCRJr, KawasCH, KlunkWE, KoroshetzWJ, ManlyJJ, MayeuxR, MohsRC, MorrisJC, RossorMN, ScheltensP, CarrilloMC, ThiesB, WeintraubS, PhelpsCH (2011) The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement7, 263–269.
18.
FolsteinMF, FolsteinSE, McHughPR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res12, 189–198.
19.
CarlesimoGA, CaltagironeC, GainottiG (1996) The Mental Deterioration Battery: Normative data, diagnostic reliability and qualitative analyses of cognitive impairment. The Group for the Standardization of the Mental Deterioration Battery. Eur Neurol36, 378–384.
20.
NovelliG, PapagnoC, CapitaniE, LaiaconaM, VallarG, CappaSF (1986) Tre test clinici di ricerca e produzione lessicale: Taratura su soggetti normali. Arch Psicol Neurol Psichiatr4, 477–506.
21.
SaricaA, VastaR, NovellinoF, VaccaroMG, CerasaA, QuattroneA; Alzheimer’s Disease Neuroimaging Initiative (2018) MRI asymmetry index of hippocampal subfields increases through the continuum from the mild cognitive impairment to the Alzheimer’s disease. Front Neurosci12, 576.
22.
LodiR, ParchiP, TononC, MannersD, CapellariS, StrammielloR, RinaldiR, TestaC, MalucelliE, MostacciB, RizzoG, PierangeliG, CortelliP, MontagnaP, BarbiroliB (2009) Magnetic resonance diagnostic markers in clinically sporadic prion disease: A combined brain magnetic resonance imaging and spectroscopy study. Brain132, 2669–2679.
23.
ProvencherS.W (2001) Automatic quantitation of localized in vivo 1H spectra with LCModel. NMR Biomed14, 260–264.
24.
ZanigniS, TestaC, Calandra-BuonauraG, SambatiL, GuarinoM, GabelliniA, EvangelistiS, CortelliP, LodiR, TononC (2015) The contribution of cerebellar proton magnetic resonance spectroscopy in the differential diagnosis among parkinsonian syndromes. Parkinsonism Relat Disord21, 929–937.
25.
MazuelL, ChassainC, JeanB, PereiraB, CladièreA, SpezialeC, DurifF (2016) Proton MR spectroscopy for diagnosis and evaluation of treatment efficacy in Parkinson disease. Radiology278, 505–513.
26.
KalraS (2019) Magnetic resonance spectroscopy in ALS. Front Neurol10, 482.
27.
KantarciK, JichaGA (2019) Development of 1H MRS biomarkers for tracking early predementia Alzheimer disease. Neurology92, 209–210.
28.
VoevodskayaO, PoulakisK, SundgrenP, van WestenD, PalmqvistS, WahlundLO, StomrudE, HanssonO, WestmanE, Swedish BioFINDER Study Group (2019) Brain myoinositol as a potential marker of amyloid-related pathology: A longitudinal study. Neurology92, e395–e405.
29.
VoevodskayaO, SundgrenPC, StrandbergO, ZetterbergH, MinthonL, BlennowK, WahlundLO, WestmanE, HanssonO, Swedish BioFINDER study group (2016) Myo-inositol changes precede amyloid pathology and relate to APOE genotype in Alzheimer disease. Neurology86, 1754–1761.
30.
WestmanE, WahlundLO, FoyC, PoppeM, CooperA, MurphyD, SpengerC, LovestoneS, SimmonsA (2010) Combining MRI and MRS to distinguish between Alzheimer’s disease and healthy controls. J Alzheimers Dis22, 171–181.
31.
RogalskiE, CobiaD, MartersteckA, RademakerA, WienekeC, WeintraubS, MesulamMM (2014) Asymmetry of cortical decline in subtypes of primary progressive aphasia. Neurology83, 1184–1191.
32.
KimG, AhmadianSS, PetersonM, PartonZ, MemonR, WeintraubS, RademakerA, BigioE, MesulamMM, GeulaC (2016) Asymmetric pathology in primary progressive aphasia with progranulin mutations and TDP inclusions. Neurology86, 627–636.
