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 PIB PET in 3 autopsy-confirmed PDD cases 
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
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Post PIB PET in 3 autopsy-confirmed PDD cases
In this Univ of Rochester (NY) study, 3 people with PDD were given PIB PET imaging within 15 months of death; 2 were PIB positive and one was PIB negative. All 3 brains were donated upon death, and the patients were found to have had "abundant cortical Lewy bodies." (There's no diagnostic criteria for PDD so this is as close as one can get.)

In conclusion, the authors argue that PIB PET is a valuable tool in patients with Lewy body disorders. I must've missed something because I don't see -- from this abstract -- how PIB PETs are useful in LBD/PDD/PD. If you think you can explain this, please do so!

Robin



Neurology. 2010 Jan 5;74(1):77-84.

In vivo amyloid imaging in autopsy-confirmed Parkinson disease with dementia.

Burack MA, Hartlein J, Flores HP, Taylor-Reinwald L, Perlmutter JS, Cairns NJ.

Department of Neurology and Pediatrics, University of Rochester Medical Center, Rochester, NY

OBJECTIVE: To investigate the specificity of in vivo amyloid imaging with [(11)C]-Pittsburgh Compound B (PIB) in Parkinson disease dementia (PDD).

METHODS: We performed detailed neuropathologic examination for 3 individuals with PDD who had PIB PET imaging within 15 months of death.

RESULTS: We observed elevated cortical uptake of [(11)C]-PIB on in vivo PET imaging in 2 of the 3 cases. At autopsy, all 3 individuals had abundant cortical Lewy bodies (Braak PD stage 6), and were classified as low-probability Alzheimer disease (AD) based on NIA-Reagan criteria.

The 2 PIB-positive individuals had abundant diffuse Abeta plaques but only sparse neuritic plaques and intermediate neurofibrillary tangle pathology. The PIB-negative individual had rare diffuse plaques, no neuritic plaques, and low neurofibrillary tangle burden.

CONCLUSIONS: [(11)C]-Pittsburgh Compound B (PIB) PET is specific for fibrillar Abeta molecular pathology but not for pathologic diagnosis of comorbid Alzheimer disease in individuals with Parkinson disease dementia. The ability to specifically identify fibrillar Abeta amyloid in the setting of alpha-synucleinopathy makes [(11)C]-PIB PET a valuable tool for prospectively evaluating how the presence of Abeta amyloid influences the clinical course of dementia in patients with Lewy body disorders.

PubMed ID#: 20038776


Wed Dec 30, 2009 1:54 pm
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Joined: Wed Dec 30, 2009 1:46 pm
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Location: WA
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Seems to me that diagnostic criteria in these cases are only really useful if they change either the prognosis or the treatment. Right now, patients are treated on a symptomatic basis and I can't see that changing any time soon. If enough post-mortem brain examinations show a reliable pattern [which they don't seem to do at this point], a predictive scan might be of use. Just MHO, of course. :wink:


Fri Jan 08, 2010 7:04 pm
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