Clinicopathological Correlation: Dopamine and Amyloid PET Imaging with Neuropathology in Three Subjects Clinically Diagnosed with Alzheimer's Disease or Dementia with Lewy Bodies
Document Type
Article
Abstract
Background: Imaging biomarkers have the potential to distinguish between different brain pathologies based on the type of ligand used with PET. AV-45 PET (florbetapir, Amyvid™) is selective for the neuritic plaque amyloid of Alzheimer's disease (AD), while AV-133 PET (florbenazine) is selective for VMAT2, which is a dopaminergic marker. Objective: To report the clinical, AV-133 PET, AV-45 PET, and neuropathological findings of three clinically diagnosed dementia patients who were part of the Avid Radiopharmaceuticals AV133-B03 study as well as the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND). Methods: Three subjects who had PET imaging with both AV-133 and AV-45 as well as a standardized neuropathological assessment were included. The final clinical, PET scan, and neuropathological diagnoses were compared. Results: The clinical and neuropathological diagnoses were made blinded to PET scan results. The first subject had a clinical diagnosis of dementia with Lewy bodies (DLB); AV-133 PET showed bilateral striatal dopaminergic degeneration, and AV-45 PET was positive for amyloid. The final clinicopathological diagnosis was DLB and AD. The second subject was diagnosed clinically with probable AD; AV-45 PET was positive for amyloid, while striatal AV-133 PET was normal. The final clinicopathological diagnosis was DLB and AD. The third subject had a clinical diagnosis of DLB. Her AV-45 PET was positive for amyloid and striatal AV-133 showed dopaminergic degeneration. The final clinicopathological diagnosis was multiple system atrophy and AD. Conclusion: PET imaging using AV-133 for the assessment of striatal VMAT2 density may help distinguish between AD and DLB. However, some cases of DLB with less-pronounced nigrostriatal dopaminergic neuronal loss may be missed.
Publication Date
1-1-2021
Publication Title
Journal of Alzheimer's Disease
ISSN
13872877
E-ISSN
18758908
Volume
80
Issue
4
First Page
1603
Last Page
1612
PubMed ID
33720879
Digital Object Identifier (DOI)
10.3233/JAD-200323
Recommended Citation
Gupta, Harsh V.; Beach, Thomas G.; Mehta, Shyamal H.; Shill, Holly A.; Driver-Dunckley, Erika; Sabbagh, Marwan N.; Belden, Christine M.; Liebsack, Carolyn; Dugger, Brittany N.; Serrano, Geidy E.; Sue, Lucia I.; Siderowf, Andrew; Pontecorvo, Michael J.; Mintun, Mark A.; Joshi, Abhinay D.; and Adler, Charles H., "Clinicopathological Correlation: Dopamine and Amyloid PET Imaging with Neuropathology in Three Subjects Clinically Diagnosed with Alzheimer's Disease or Dementia with Lewy Bodies" (2021). Neurology. 816.
https://scholar.barrowneuro.org/neurology/816