Alzheimer's & dementia (Amsterdam, Netherlands) · 2026
Regional amyloid PET asymmetry and long-term clinical trajectory in mild cognitive impairment.
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Lee Yunjin, Kang Sungwoo, Kim Yong Sung, Kim June Sic, Kim Hee-Jin
Аннотация
INTRODUCTION: Hemispheric amyloid positron emission tomography (PET) asymmetry may capture prognostic information beyond binary amyloid status in amnestic mild cognitive impairment (aMCI).
METHODS: We retrospectively studied 158 aMCI patients with baseline 18F-florbetaben PET and magnetic resonance imaging acquired within 12 months and a mean follow-up of 6.89 ± 2.63 years. Participants were classified as amyloid beta (Aβ)- stable (n = 67), Aβ- progressor (n = 18), Aβ+ stable (n = 33), or Aβ+ progressor (n = 40). Vertex-wise cortical standardized uptake value ratio (SUVR) asymmetry (|AI|) was analyzed using surface-based general linear models adjusted for age, sex, education years, apolipoprotein E ε4 carrier status, global cortical SUVR, and clinical follow-up duration.
RESULTS: Aβ- MCI progressors showed higher |AI| in the lateral orbitofrontal cortex (790 vertices, cluster-wise p = 0.0002). Aβ+ MCI progressors showed lower |AI| in the lingual gyrus (478 vertices, cluster-wise p = 0.0001). No cross-status contrast yielded a significant cluster in the covariate-adjusted model.
DISCUSSION: Amyloid PET asymmetry reflects prognostic heterogeneity in aMCI, with distinct distributional patterns according to amyloid status.
METHODS: We retrospectively studied 158 aMCI patients with baseline 18F-florbetaben PET and magnetic resonance imaging acquired within 12 months and a mean follow-up of 6.89 ± 2.63 years. Participants were classified as amyloid beta (Aβ)- stable (n = 67), Aβ- progressor (n = 18), Aβ+ stable (n = 33), or Aβ+ progressor (n = 40). Vertex-wise cortical standardized uptake value ratio (SUVR) asymmetry (|AI|) was analyzed using surface-based general linear models adjusted for age, sex, education years, apolipoprotein E ε4 carrier status, global cortical SUVR, and clinical follow-up duration.
RESULTS: Aβ- MCI progressors showed higher |AI| in the lateral orbitofrontal cortex (790 vertices, cluster-wise p = 0.0002). Aβ+ MCI progressors showed lower |AI| in the lingual gyrus (478 vertices, cluster-wise p = 0.0001). No cross-status contrast yielded a significant cluster in the covariate-adjusted model.
DISCUSSION: Amyloid PET asymmetry reflects prognostic heterogeneity in aMCI, with distinct distributional patterns according to amyloid status.