Florbetapir PET Measurements of Amyloid Plaque Deposition are More Closely Correlated with Cross‐Sectional and Longitudinal Cognitive and Clinical Measurements Using a White Matter Reference Region of Interest

Abstract

AbstractBackgroundWe previously reported stronger associations of FDG‐PET measured glucose hypometabolism with florbetapir PET measured Aβ deposition quantified using Standard Uptake Value Ratio (SUVR) with a cerebral white matter reference region (SUVRwm) compared to the commonly used SUVR with cerebellar reference region (SUVRcrblm) both cross‐sectionally and longitudinally (Wang et al., AAIC 2021). This study compared cross‐sectional and longitudinal associations of SUVRwm and SUVRcrblm with various cognitive/clinical measuresMethodOur study population consisted of 1133 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) including 206 participants clinically diagnosed with AD dementia, 563 with Mild Cognitive Impairment (MCI), and 364 cognitively unimpaired individuals (CU). We computed partial correlation of SUVRwm or SUVRcrblm, covarying out baseline age and years of education, with Mini Mental State Exam (MMSE); Clinical Dementia Rating Scale Sum Boxes and Global (CDR‐SB and CDGlobal); Alzheimer’s Disease Assessment Scale (ADAS11, ADAS13); Auditory Verbal Learning Test – Short Term Memory, Long Term Memory, and Total (AVLT STM, AVLT LTM, and AVLT Total respectively). Steiger’s Z‐test was used to compare SUVRwm and SUVRcrblm correlation coefficient differences with each of these cognitive/clinical measures at uncorrected p = 0.05 significance. Analyses were carried out over all subjects and within each diagnostic group, first for baseline data and then longitudinally.ResultCross sectionally, correlations were significantly stronger with SUVRwm than with SUVRcrblm for all subjects in all cognitive/clinical measures (all p<1.314E‐04) with the strongest correlation of SUVRwmRef with MMSE (r = ‐0.4717 for SUVRwm and r = ‐0.3463 for SUVRcrblm; p = 1.93E‐13). The strongest correlation within AD subjects was found between SUVRwm and MMSE (r = ‐0.1432 for SUVRwm and r = 0.0459 for SUVRcrblm; p = 9.7063E‐04).Longitudinally, stronger SUVRwm correlations than SUVRcrblm with each of these cognitive measures were also observed over all subjects (p<0.05), and significance with CDR‐SB and AVLT Total in AD; with MMSE, ADAS11, ADAS13, CDGlobal, CDR‐SB, AVLT Total in MCI; and with CDGlobal in CU.ConclusionThe use of cerebral white matter reference region for florbetapir PET SUVR quantification demonstrated stronger associations between amyloid deposition and cognitive measures than cerebellar reference region.