Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia

Abstract Purpose The loss of olfactory function is known to occur in patients suffering from (behavioral variant) frontotemporal dementia ((bv)FTD) and Alzheimer’s disease (AD), although different pathophysiological mechanisms underpin this clinical symptom in both disorders. This study assessed whe...

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Main Authors: Daniël S. L. Loewenstein, Max van Grinsven, Cécile de Pont, Paul L. J. Dautzenberg, Astrid M. van Strien, Dylan Henssen
Format: Article
Language:English
Published: BMC 2024-10-01
Series:Alzheimer’s Research & Therapy
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Online Access:https://doi.org/10.1186/s13195-024-01604-7
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author Daniël S. L. Loewenstein
Max van Grinsven
Cécile de Pont
Paul L. J. Dautzenberg
Astrid M. van Strien
Dylan Henssen
author_facet Daniël S. L. Loewenstein
Max van Grinsven
Cécile de Pont
Paul L. J. Dautzenberg
Astrid M. van Strien
Dylan Henssen
author_sort Daniël S. L. Loewenstein
collection DOAJ
description Abstract Purpose The loss of olfactory function is known to occur in patients suffering from (behavioral variant) frontotemporal dementia ((bv)FTD) and Alzheimer’s disease (AD), although different pathophysiological mechanisms underpin this clinical symptom in both disorders. This study assessed whether brain metabolism of the olfactory circuit as assessed by positron emission tomography (PET) imaging with 2-[fluorine-18]fluoro-2-deoxy-d-glucose ([18F]-FDG) can distinguish these entities in different subsets of patients. Methods Patients presenting with cognitive decline were included from a prospectively kept database: (1) bvFTD patients, (2) AD patients and (3) patients with logopenic primary progressive aphasia (PPA). Metabolic rates were calculated for different regions of the olfactory circuit for each subgroup and compared with a cohort of subjects with normal brain metabolism. Additionally, in patients with a logopenic PPA pattern on PET-imaging, statistical parametric mapping (SPM) analysis was performed. Results The metabolism of subdivisions of the olfactory circuit as assessed by [18F]-FDG PET brain imaging to bvFTD and AD from control subjects resulted in sensitivity/specificity rates of 95/87.5% and 80/83.3%, respectively. A sensitivity/specificity rate of 100/87.5% was achieved when used to differentiate AD from bvFTD. In patients with the PPA pattern on imaging, the underlying cause (either FTD or AD) could be determined with a sensitivity/specificity rate of 88/82%. SPM analysis concurred that different regions of the olfactory circuit were affected in patients suffering from AD PPA or bvFTD PPA. Conclusion Metabolic dysfunction in the olfactory circuit is different in various neurodegenerative disorders. Further investigation of the correlations between the cerebral metabolism and the mechanisms which drive olfactory dysfunction is needed.
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spelling doaj-art-536b606e19f640d2af5d6afc99b0bdfb2025-08-20T02:18:20ZengBMCAlzheimer’s Research & Therapy1758-91932024-10-0116111110.1186/s13195-024-01604-7Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementiaDaniël S. L. Loewenstein0Max van Grinsven1Cécile de Pont2Paul L. J. Dautzenberg3Astrid M. van Strien4Dylan Henssen5Department of Medical Imaging, Radboud University Medical CenterDepartment of Medical Imaging, Radboud University Medical CenterDepartment of Medical Imaging, Jeroen Bosch HospitalDepartment of Geriatrics, Jeroen Bosch HospitalDepartment of Geriatrics, Jeroen Bosch HospitalDepartment of Medical Imaging, Radboud University Medical CenterAbstract Purpose The loss of olfactory function is known to occur in patients suffering from (behavioral variant) frontotemporal dementia ((bv)FTD) and Alzheimer’s disease (AD), although different pathophysiological mechanisms underpin this clinical symptom in both disorders. This study assessed whether brain metabolism of the olfactory circuit as assessed by positron emission tomography (PET) imaging with 2-[fluorine-18]fluoro-2-deoxy-d-glucose ([18F]-FDG) can distinguish these entities in different subsets of patients. Methods Patients presenting with cognitive decline were included from a prospectively kept database: (1) bvFTD patients, (2) AD patients and (3) patients with logopenic primary progressive aphasia (PPA). Metabolic rates were calculated for different regions of the olfactory circuit for each subgroup and compared with a cohort of subjects with normal brain metabolism. Additionally, in patients with a logopenic PPA pattern on PET-imaging, statistical parametric mapping (SPM) analysis was performed. Results The metabolism of subdivisions of the olfactory circuit as assessed by [18F]-FDG PET brain imaging to bvFTD and AD from control subjects resulted in sensitivity/specificity rates of 95/87.5% and 80/83.3%, respectively. A sensitivity/specificity rate of 100/87.5% was achieved when used to differentiate AD from bvFTD. In patients with the PPA pattern on imaging, the underlying cause (either FTD or AD) could be determined with a sensitivity/specificity rate of 88/82%. SPM analysis concurred that different regions of the olfactory circuit were affected in patients suffering from AD PPA or bvFTD PPA. Conclusion Metabolic dysfunction in the olfactory circuit is different in various neurodegenerative disorders. Further investigation of the correlations between the cerebral metabolism and the mechanisms which drive olfactory dysfunction is needed.https://doi.org/10.1186/s13195-024-01604-7Alzheimer’s diseaseFrontotemporal dementiaFDG PETNeurodegenerative disordersNeuroimagingOlfactory system
spellingShingle Daniël S. L. Loewenstein
Max van Grinsven
Cécile de Pont
Paul L. J. Dautzenberg
Astrid M. van Strien
Dylan Henssen
Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia
Alzheimer’s Research & Therapy
Alzheimer’s disease
Frontotemporal dementia
FDG PET
Neurodegenerative disorders
Neuroimaging
Olfactory system
title Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia
title_full Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia
title_fullStr Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia
title_full_unstemmed Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia
title_short Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer’s disease or frontotemporal dementia
title_sort assessing the metabolism of the olfactory circuit by use of 18f fdg pet ct imaging in patients suspected of suffering from alzheimer s disease or frontotemporal dementia
topic Alzheimer’s disease
Frontotemporal dementia
FDG PET
Neurodegenerative disorders
Neuroimaging
Olfactory system
url https://doi.org/10.1186/s13195-024-01604-7
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