Behavioral variant frontotemporal dementia (bvFTD): PET biomarker characterization of metabolism (18F-FDG), amyloid (11C-PIB) and tau (18F-AV1451) and its clinical correlate - analysis of a cohort from Argentina

Abstract

Introduction: Imaging biomarkers are fundamental in diagnosing neurodegenerative diseases, but their use in FTD remains limited. This study examines PET biomarkers in Argentine bvFTD patients.

Methods: We studied a cohort of bvFTD patients (n = 20) and controls (n = 21) with three different PET radiotracers (18F-FDG, 11C-PiB, and 18F-AV1451).

Results: In bvFTD patients, 18F-FDG PET showed significant hypometabolism in frontotemporal regions, along with hypermetabolism in the precentral gyrus, compared to normal controls. 11C-PIB did not reveal a pattern typical of Alzheimer's disease, yet increased uptake was notably observed in the precentral region. We found 18F-AV1451 uptake in frontal lobe, parietal, precuneus, cuneus, posterior cingulum, highly significant in bvFTD with respect to NCs.

Discussion: PET biomarkers are a crucial tool in diverse real-world clinical scenarios. However, their utility in revealing questions about the underlying pathology in FTD is still limited.

Highlights: First bvFTD study using 18F-FDG, 11C-PIB, and 18F-AV1451 PET in a Latin American cohort. Frontotemporal hypometabolism with compensatory precentral hypermetabolism due to amyloid. Amyloid deposits observed in the precentral gyrus without an Alzheimer's-like pattern. 18F-AV1451 shows limitations in specificity for bvFTD pathology. Study provides new insights into PET biomarker utility for bvFTD clinical assessment.