Open AccessAmyloid‐ β PET and CSF in an autopsy‐confirmed cohort
Author(s) -
Reimand Juhan,
Boon Baayla D. C.,
Collij Lyduine E.,
Teunissen Charlotte E.,
Rozemuller Annemieke J. M.,
Berckel Bart N. M.,
Scheltens Philip,
Ossenkoppele Rik,
Bouwman Femke
Publication year - 2020
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51195
Subject(s) - medicine , pathology , cerebrospinal fluid , neuropathology , amyloid (mycology) , autopsy , positron emission tomography , dementia , disease , nuclear medicine
Objective Accumulation of amyloid‐ β is among the earliest changes in Alzheimer’s disease (AD). Amyloid‐ β positron emission tomography (PET) and A β 42 in cerebrospinal fluid (CSF) both assess amyloid‐ β pathology in‐vivo, but 10–20% of cases show discordant (CSF+/PET− or CSF‐/PET+) results. The neuropathological correspondence with amyloid‐ β CSF/PET discordance is unknown. Methods We included 21 patients from our tertiary memory clinic who had undergone both CSF A β 42 analysis and amyloid‐ β PET, and had neuropathological data available. Amyloid‐ β PET and CSF results were compared with neuropathological ABC scores (comprising of Thal (A), Braak (B), and CERAD (C) stage, all ranging from 0 [low] to 3 [high]) and neuropathological diagnosis. Results Neuropathological diagnosis was AD in 11 (52%) patients. Amyloid‐ β PET was positive in all A3, C2, and C3 cases and in one of the two A2 cases. CSF A β 42 was positive in 92% of ≥A2 and 90% of ≥C2 cases. PET and CSF were discordant in three of 21 (14%) cases: CSF+/PET− in a patient with granulomatosis with polyangiitis (A0B0C0), CSF+/PET− in a patient with FTLD‐TDP type B (A2B1C1), and CSF‐/PET+ in a patient with AD (A3B3C3). Two CSF+/PET+ cases had a non‐AD neuropathological diagnosis, that is FTLD‐TDP type E (A3B1C1) and adult‐onset leukoencephalopathy with axonal spheroids (A1B1C0). Interpretation Our study demonstrates neuropathological underpinnings of amyloid‐ β CSF/PET discordance. Furthermore, amyloid‐ β biomarker positivity on both PET and CSF did not invariably result in an AD diagnosis at autopsy, illustrating the importance of considering relevant comorbidities when evaluating amyloid‐ β biomarker results.