11C PIB PET Is associated with the brain biopsy amyloid-β load in subjects examined for normal pressure hydrocephalus

Juha O. Rinne*, Timo Suotunen, Jaana Rummukainen, Sanna Kaisa Herukka, Ossi Nerg, Anne M. Koivisto, Tuomas Rauramaa, Kjell Någren, Mikko Hiltunen, Irina Alafuzoff, Jaakko Rinne, Juha E. Jääskeläinen, Hilkka Soininen, Ville Leinonen

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


Background: Idiopathic normal pressure hydrocephalus (iNPH) is frequently associated with concomitant amyloid-β (Aβ) pathology. Objective: To compare the [ 11 C]PIB PET uptake in the patients with suspected iNPH to Aβ and hyperphosphorylated-tau (HPτ) in the right frontal cortical biopsy, the cerebrospinal fluid (CSF) Aβ, the response to a CSF shunt, and the final clinical diagnosis of Alzheimer's disease (AD). Methods: Patients (n = 21) from Kuopio NPH Registry (http://www.uef.fi/nph) with intraventricular pressure monitoring, immunostaining for Aβ and HPτ in the right frontal cortical biopsies, and a Mini-Mental State Examination and a Clinical Dementia Rating underwent [ 11 C]PIB PET. Aβ, total tau, and Pτ 181 were measured by ELISA from the ventricular (n = 15) and the lumbar (n = 9) CSF. Response to the shunt was seen in 13 out of the 15 shunted patients. AD was diagnosed in 8 patients during a median follow-up of 6 years (mean 7.3±2.4 years, range 3-1). Results: [ 11 C]PIB uptake in the right frontal cortex (ρ= 0.60, p < 0.01) and the combined neocortical [ 11 C]PIB uptake score (ρ= 0.61, p < 0.01) were associated with a higher Aβ load in the right frontal cortical biopsy. Excluding one (1/15) outlier, [ 11 C]PIB uptake was also associated with the ventricular CSF Aβ (ρ= -0.58, p = 0.03). Conclusions: The findings show that [ 11 C]PIB PET can reliably detect simultaneous amyloid pathology among the iNPH patients. Further studies will show whether amyloid PET could predict a clinical response to the shunt operation. In addition, the presence of Aβ pathology in the patients with iNPH might also warrant treatment with current AD drugs.

TidsskriftJournal of Alzheimer's Disease
Udgave nummer4
Sider (fra-til)1343-1351
StatusUdgivet - 2019

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