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      Positron emission tomography imaging of tau pathology in progressive supranuclear palsy

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          Abstract

          Progressive supranuclear palsy is a rare form of atypical Parkinsonism that differs neuropathologically from other parkinsonian disorders. While many parkinsonian disorders such as Parkinson’s disease, Lewy body dementia, and multiple system atrophy are classified as synucleinopathies, progressive supranuclear palsy is coined a tauopathy due to the aggregation of pathological tau in the brain. [ 18F]AV-1451 (also known as [ 18F]-T807) is a positron emission tomography radiotracer that binds to paired helical filaments of tau in Alzheimer’s disease. We investigated whether [ 18F]AV-1451 could be used as biomarker for the diagnosis and disease progression monitoring in progressive supranuclear palsy. Six progressive supranuclear palsy, six Parkinson’s disease, and 10 age-matched healthy controls were recruited. An anatomical MRI and a 90-min PET scan, using [ 18F]AV-1451, were acquired from all participants. The standardized uptake value ratio from 60 to 90 min post-injection was calculated in each region of interest, using the cerebellar cortex as a reference region. No significant differences in standardized uptake value ratios were detected in our progressive supranuclear palsy group compared to the two control groups. [ 18F]AV-1451 may bind selectivity to the paired helical filaments in Alzheimer’s disease, which differ from the straight conformation of tau filaments in progressive supranuclear palsy.

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          A clinical rating scale for progressive supranuclear palsy.

          We devised a Progressive Supranuclear Palsy (PSP) Rating Scale comprising 28 items in six categories: daily activities (by history), behaviour, bulbar, ocular motor, limb motor and gait/midline. Scores range from 0 to 100, each item graded 0-2 (six items) or 0-4 (22 items). Inter-rater reliability is good, with intra-class correlation coefficient for the overall scale of 0.86 (95% CI 0.65-0.98). A single examiner applied the PSPRS at every visit for 162 patients. Mean rate of progression was 11.3 (+/-11.0) points per year. Neither onset age nor gender correlated well with rate of progression. Median actuarially corrected survival was 7.3 years. The PSPRS score was a good independent predictor of subsequent survival (P < 0.0001). For example, for patients with scores from 40 to 49, 3-year survival was 41.9% (95% CI 31.0-56.6) but 4-year survival was only 17.9% (95% CI 10.2-31.5). For those patients, likelihood or retaining some gait function was 51.7% (40.0-66.9) at 1 year but only 6.5% (1.8-23.5) at 3 years. We conclude that the PSPRS is a practical measure that is sensitive to disease progression and could be useful as a dependent variable in observational or interventional trials and as an indicator of prognosis in clinical practice.
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            Is Open Access

            The Importance of Tau Phosphorylation for Neurodegenerative Diseases

            Fibrillar deposits of highly phosphorylated tau are a key pathological feature of several neurodegenerative tauopathies including Alzheimer’s disease (AD) and some frontotemporal dementias. Increasing evidence suggests that the presence of these end-stage neurofibrillary lesions do not cause neuronal loss, but rather that alterations to soluble tau proteins induce neurodegeneration. In particular, aberrant tau phosphorylation is acknowledged to be a key disease process, influencing tau structure, distribution, and function in neurons. Although typically described as a cytosolic protein that associates with microtubules and regulates axonal transport, several additional functions of tau have recently been demonstrated, including roles in DNA stabilization, and synaptic function. Most recently, studies examining the trans-synaptic spread of tau pathology in disease models have suggested a potential role for extracellular tau in cell signaling pathways intrinsic to neurodegeneration. Here we review the evidence showing that tau phosphorylation plays a key role in neurodegenerative tauopathies. We also comment on the tractability of altering phosphorylation-dependent tau functions for therapeutic intervention in AD and related disorders.
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              Characterization of tau positron emission tomography tracer [(18)F]AV-1451 binding to postmortem tissue in Alzheimer's disease, primary tauopathies, and other dementias.

              Aggregation of tau is a hallmark of many neurodegenerative diseases, and tau imaging with positron emission tomography (PET) may allow early diagnosis and treatment monitoring. We assessed binding of the PET tracer [(18)F]AV-1451 in a range of dementias.
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                Author and article information

                Journal
                J Cereb Blood Flow Metab
                J. Cereb. Blood Flow Metab
                JCB
                spjcb
                Journal of Cerebral Blood Flow & Metabolism
                SAGE Publications (Sage UK: London, England )
                0271-678X
                1559-7016
                22 December 2016
                September 2017
                : 37
                : 9
                : 3150-3160
                Affiliations
                [1 ]Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
                [2 ]Division of Brain, Imaging and Behaviour – Systems Neuroscience, Krembil Research Institute, UHN, University of Toronto, Toronto, ON, Canada
                [3 ]Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Program in Parkinson Disease, Neurology Division, Department of Medicine, Toronto Western Hospital, UHN, University of Toronto, Toronto, ON, Canada
                Author notes
                [*]Antonio P Strafella, Toronto Western Hospital and Institute CAMH-Research Imaging Centre, University of Toronto, Toronto, ON, Canada M5T 2S8. Email: antonio.strafella@ 123456camh.ca
                Article
                PMC5584690 PMC5584690 5584690 10.1177_0271678X16683695
                10.1177/0271678X16683695
                5584690
                28155586
                efc97d13-4a04-4ea9-b582-051aacc4f2ab
                © The Author(s) 2016
                History
                : 16 September 2016
                : 7 November 2016
                : 10 November 2016
                Categories
                Original Articles

                positron emission tomography,Brain imaging,movement disorder,neuropathology,Parkinson’s disease

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