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  Differential diagnosis between Alzheimer’s disease-related depression and pseudo-dementia in depression: A new indication for amyloid-β imaging?

Leonhardi, J., Barthel, H., Speerforck, S., Dietzel, J., Schroeter, M. L., Saur, D., et al. (2022). Differential diagnosis between Alzheimer’s disease-related depression and pseudo-dementia in depression: A new indication for amyloid-β imaging? Journal of Alzheimer's Disease. doi:10.3233/JAD-215619.

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 Creators:
Leonhardi, Jakob1, 2, Author
Barthel, Henryk1, Author
Speerforck, Sven3, Author
Dietzel, Jens3, Author
Schroeter, Matthias L.4, 5, Author              
Saur, Dorothee6, Author
Tiepolt, Solveig1, Author
Rullmann, Michael1, Author
Patt, Marianne1, Author
Claßen, Joseph6, Author
Schomerus, Georg3, Author
Sabri, Osama1, Author
Affiliations:
1Department of Nuclear Medicine, University of Leipzig, Germany, ou_persistent22              
2Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Germany, ou_persistent22              
3Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Germany, ou_persistent22              
4Clinic for Cognitive Neurology, University of Leipzig, Germany, ou_persistent22              
5Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
6Department of Neurology, University Hospital Leipzig, Germany, ou_persistent22              

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Free keywords: Alzheimer’s disease; [18F]florbetaben; Amyloid PET imaging; Amyloid-β; Depression; Mild cognitive impairment; Pittsburgh compound B; Pseudo-dementia
 Abstract: Background: Alzheimer's disease and depression can start with combined cognitive and depressive symptoms [1, 2]. Accurate differential diagnosis is desired to initiate specific treatment. Objective: We investigated whether amyloid-β PET imaging can discriminate both entities. Methods: This retrospective observational study included 39 patients (20 female, age = 70±11years) with both cognitive and depressive symptoms who underwent amyloid-β PET imaging and in whom clinical follow-up data was available. Amyloid-β PET was carried out applying [18F]Florbetaben or [11C]PiB. The PET images were analyzed by standardized visual and relative-quantitative evaluation. Based on clinical follow-up (median of 2.4 years [range 0.3 to 7.0 years, IQR = 3.7 years] after amyloid PET imaging which was not considered in obtaining a definite diagnosis), discrimination ability between AD-related depression and pseudo-dementia in depression/depression with other comorbidities was determined. Results: Visually, all 10 patients with pseudo-dementia in depression and all 15 patients with other depression were rated as amyloid-β-negative; 2 of 14 patients with AD-related depression were rated amyloid-β-negative. ROC curve analysis of the unified composite standardized uptake value ratios (cSUVRs) was able to discriminate pseudo-dementia in depression from AD-related depression with high accuracy (AUC = 0.92). Optimal [18F]Florbetaben discrimination cSUVR threshold was 1.34. In congruence with the visual PET analysis, the resulting sensitivity of the relative-quantitative analysis was 86% with a specificity of 100% . Conclusion: Amyloid-β PET can differentiate AD-related depression and pseudo-dementia in depression. Prospective clinical studies are warranted to confirm this result and to potentially broaden the spectrum of clinical applications for amyloid-β PET imaging.

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Language(s): eng - English
 Dates: 2022-05-162022-06-13
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.3233/JAD-215619
Other: online ahead of print
PMID: 35723098
 Degree: -

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Title: Journal of Alzheimer's Disease
  Abbreviation : J. Alzheimers Dis.
Source Genre: Journal
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Affiliations:
Publ. Info: Amsterdam : IOS Press
Pages: - Volume / Issue: - Sequence Number: - Start / End Page: - Identifier: ISSN: 1387-2877
CoNE: https://pure.mpg.de/cone/journals/resource/1387-2877