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Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study

BACKGROUND: MRI studies reported that ALS patients with bulbar and spinal onset showed focal cortical changes in corresponding regions of the motor homunculus. We evaluated the capability of brain 2-[(18)F]FDG-PET to disclose the metabolic features characterizing patients with pure bulbar or spinal...

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Autores principales: Canosa, Antonio, Martino, Alessio, Giuliani, Alessandro, Moglia, Cristina, Vasta, Rosario, Grassano, Maurizio, Palumbo, Francesca, Cabras, Sara, Di Pede, Francesca, De Mattei, Filippo, Matteoni, Enrico, Polverari, Giulia, Manera, Umberto, Calvo, Andrea, Pagani, Marco, Chiò, Adriano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886651/
https://www.ncbi.nlm.nih.gov/pubmed/36322237
http://dx.doi.org/10.1007/s00415-022-11445-9
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author Canosa, Antonio
Martino, Alessio
Giuliani, Alessandro
Moglia, Cristina
Vasta, Rosario
Grassano, Maurizio
Palumbo, Francesca
Cabras, Sara
Di Pede, Francesca
De Mattei, Filippo
Matteoni, Enrico
Polverari, Giulia
Manera, Umberto
Calvo, Andrea
Pagani, Marco
Chiò, Adriano
author_facet Canosa, Antonio
Martino, Alessio
Giuliani, Alessandro
Moglia, Cristina
Vasta, Rosario
Grassano, Maurizio
Palumbo, Francesca
Cabras, Sara
Di Pede, Francesca
De Mattei, Filippo
Matteoni, Enrico
Polverari, Giulia
Manera, Umberto
Calvo, Andrea
Pagani, Marco
Chiò, Adriano
author_sort Canosa, Antonio
collection PubMed
description BACKGROUND: MRI studies reported that ALS patients with bulbar and spinal onset showed focal cortical changes in corresponding regions of the motor homunculus. We evaluated the capability of brain 2-[(18)F]FDG-PET to disclose the metabolic features characterizing patients with pure bulbar or spinal motor impairment. METHODS: We classified as pure bulbar (PB) patients with bulbar onset and a normal score in the spinal items of the ALSFRS-R, and as pure spinal (PS) patients with spinal onset and a normal score in the bulbar items at the time of PET. Forty healthy controls (HC) were enrolled. We compared PB and PS, and each patient group with HC. Metabolic clusters showing a statistically significant difference between PB and PS were tested to evaluate their accuracy in discriminating the two groups. We performed a leave-one-out cross-validation (LOOCV) over the entire dataset. Four classifiers were considered: support vector machines (SVM), K-nearest neighbours, linear classifier, and decision tree. Then, we used a separate test set, including 10% of patients, with the remaining 90% composing the training set. RESULTS: We included 63 PB, 271 PS, and 40 HC. PB showed a relative hypometabolism compared to PS in bilateral precentral gyrus in the regions of the motor cortex involved in the control of bulbar function. SVM showed the best performance, resulting in the lowest error rate in both LOOCV (4.19%) and test set (9.09 ± 2.02%). CONCLUSIONS: Our data support the concept of the focality of ALS onset and the use of 2-[(18)F]FDG-PET as a biomarker for precision medicine-oriented clinical trials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11445-9.
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spelling pubmed-98866512023-02-01 Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study Canosa, Antonio Martino, Alessio Giuliani, Alessandro Moglia, Cristina Vasta, Rosario Grassano, Maurizio Palumbo, Francesca Cabras, Sara Di Pede, Francesca De Mattei, Filippo Matteoni, Enrico Polverari, Giulia Manera, Umberto Calvo, Andrea Pagani, Marco Chiò, Adriano J Neurol Original Communication BACKGROUND: MRI studies reported that ALS patients with bulbar and spinal onset showed focal cortical changes in corresponding regions of the motor homunculus. We evaluated the capability of brain 2-[(18)F]FDG-PET to disclose the metabolic features characterizing patients with pure bulbar or spinal motor impairment. METHODS: We classified as pure bulbar (PB) patients with bulbar onset and a normal score in the spinal items of the ALSFRS-R, and as pure spinal (PS) patients with spinal onset and a normal score in the bulbar items at the time of PET. Forty healthy controls (HC) were enrolled. We compared PB and PS, and each patient group with HC. Metabolic clusters showing a statistically significant difference between PB and PS were tested to evaluate their accuracy in discriminating the two groups. We performed a leave-one-out cross-validation (LOOCV) over the entire dataset. Four classifiers were considered: support vector machines (SVM), K-nearest neighbours, linear classifier, and decision tree. Then, we used a separate test set, including 10% of patients, with the remaining 90% composing the training set. RESULTS: We included 63 PB, 271 PS, and 40 HC. PB showed a relative hypometabolism compared to PS in bilateral precentral gyrus in the regions of the motor cortex involved in the control of bulbar function. SVM showed the best performance, resulting in the lowest error rate in both LOOCV (4.19%) and test set (9.09 ± 2.02%). CONCLUSIONS: Our data support the concept of the focality of ALS onset and the use of 2-[(18)F]FDG-PET as a biomarker for precision medicine-oriented clinical trials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11445-9. Springer Berlin Heidelberg 2022-11-02 2023 /pmc/articles/PMC9886651/ /pubmed/36322237 http://dx.doi.org/10.1007/s00415-022-11445-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Communication
Canosa, Antonio
Martino, Alessio
Giuliani, Alessandro
Moglia, Cristina
Vasta, Rosario
Grassano, Maurizio
Palumbo, Francesca
Cabras, Sara
Di Pede, Francesca
De Mattei, Filippo
Matteoni, Enrico
Polverari, Giulia
Manera, Umberto
Calvo, Andrea
Pagani, Marco
Chiò, Adriano
Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study
title Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study
title_full Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study
title_fullStr Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study
title_full_unstemmed Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study
title_short Brain metabolic differences between pure bulbar and pure spinal ALS: a 2-[(18)F]FDG-PET study
title_sort brain metabolic differences between pure bulbar and pure spinal als: a 2-[(18)f]fdg-pet study
topic Original Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886651/
https://www.ncbi.nlm.nih.gov/pubmed/36322237
http://dx.doi.org/10.1007/s00415-022-11445-9
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