Amnestic mild cognitive impairment (aMCI) is emerging as a heterogeneous condition.
We looked at a cohort of N = 207 aMCI subjects, with baseline fluorodeoxyglucose positron emission tomography (FDG-PET), T1 magnetic resonance imaging, cerebrospinal fluid (CSF), apolipoprotein E (APOE), and neuropsychological assessment. An algorithm based on FDG-PET hypometabolism classified each subject into subtypes, then compared biomarker measures and clinical progression.
Three subtypes emerged: hippocampal sparing–cortical hypometabolism, associated with younger age and the highest level of Alzheimer’s disease (AD)-CSF pathology; hippocampal/cortical hypometabolism, associated with a high percentage of APOE ε3/ε4 or ε4/ε4 carriers; medial–temporal hypometabolism, characterized by older age, the lowest AD-CSF pathology, the most severe hippocampal atrophy, and a benign course. Within the whole cohort, the severity of temporo-parietal hypometabolism, correlated with AD-CSF pathology and marked the rate of progression of cognitive decline.
FDG-PET can distinguish clinically comparable aMCI at single-subject level with different risk of progression to AD dementia or stability. The obtained results can be useful for the optimization of pharmacological trials and automated-classification models.

Algorithm based on FDG-PET hypometabolism demonstrates distinct subtypes across aMCI;
Three different subtypes show heterogeneous biological profiles and risk of progression;
The cortical hypometabolism is associated with AD pathology and cognitive decline;
MTL hypometabolism is associated with the lowest conversion rate and CSF-AD pathology.

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This post is Copyright: Silvia Paola Caminiti,
Silvia De Francesco,
Giacomo Tondo,
Alice Galli,
Alberto Redolfi,
Daniela Perani,
the Alzheimer’s Disease Neuroimaging Initiative,
the Interceptor Project | July 29, 2023

Wiley: Alzheimer’s & Dementia: Table of Contents