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P2‐378: Clinical and quantitative fluorodeoxyglucose positron emission tomography in presymptomatic and symptomatic persons inheriting familial Alzheimer's disease mutations
Author(s) -
Ringman John M.,
Lee Soo K.,
Barrio Jorge,
Coppola Giovanni,
Small Gary,
Cummings Jeffrey L.,
Silverman Daniel H.
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1430
Subject(s) - asymptomatic , positron emission tomography , psen1 , fluorodeoxyglucose , medicine , posterior cingulate , disease , alzheimer's disease , nuclear medicine , pathology , psychology , oncology , presenilin , radiology , functional magnetic resonance imaging
Background: The age of onset is a factor that influences the progression and severity of Alzheimer’s disease (AD). It is known that early onset AD (EOAD) evolves with a more rapid cognitive and functional decline than late onset AD (LOAD). The cause of this difference is not well known. Methods: We report two AD patients with the same educational level, but with different ages of onset of the disease. Mr C was 60 years old at the first visit and Mr W was 85 years old. Neither patient had familial history of AD. After 4 years of follow up, patients underwent C Pittsburgh Compound B (PIB) positron emission tomography (PET). Results: At the first visit, both patients had preserved autonomy (CDR 1⁄4 0.5) and disease duration was similar (around 6 to 8 months). The MMSE score was lower for Mr C than for Mr W (24/30 and 27/30 respectively). Despite the same treatment (Rivastigmine), the cognitive decline was more rapid and more severe for Mr C than for Mr W. After 12 months of follow up, MMSE scores of Mr C and Mr W were 15/30 and 28/30 respectively and, after 30 months, they were 16/30 and 28/30, respectively. At the last visit, after 4 years of follow up, MMSE scores for Mr C and for Mr. W were 10/30 and 26/30, respectively and the CDR scores were 2 and 0.5, respectively. PIB Imaging [C]PIB-PET was then performed and prominent binding of PIB was observed in several cortical regions in both patients, in accordance with the diagnosis. Surprisingly, PIB uptake in Mr C was 30 to 60 % more severe than for Mr W in all cortical regions (frontal, temporal, parietal and cingulate). Conclusions: We reported two patients with different forms of AD, regarding to the age of onset of the disease (EOAD vs LOAD). Both patients had similar clinical data for disease duration, disability at onset and treatment, but distinguished dramatically on the disease progression. PIB uptake in the EOAD patient was more severe than in LOAD case, suggesting that amyloid load intensity could explain clinical differences between EOAD and LOAD.