Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Integrated MRI and [11C]‐PBR28 PET Imaging in ALS

Ann Neurol; ePub 2018 May 8; Alshikho, et al

Glial activation measured by in vivo [11C]‐PBR28 positron emission tomography (PET) is increased in pathologically relevant regions in people with amyotrophic lateral sclerosis (ALS) and correlates with clinical measures, according to a recent study. 85 participants—including 53 ALS, 11 primary lateral sclerosis (PLS), and 21 healthy controls—underwent integrated [11C]‐PBR28 PET‐MR brain imaging. Patients were clinically assessed using the upper motor neuron burden (UMNB), and the revised ALS functional rating scale (ALSFRS‐R). [11C]‐PBR28 uptake was quantified as standardized uptake value ratio (SUVR), and compared between groups. Cortical thickness and fractional anisotropy were compared between groups and correlated with SUVR and the clinical data. Researchers found:

  • Whole brain voxel‐wise, surface‐based, and region of interest analyses revealed increased [11C]‐PBR28 uptake in the precentral and paracentral gyri in ALS, and in the sub‐cortical white matter for the same regions in PLS, compared to controls.
  • The increase in [11C]‐PBR28 uptake co‐localized and correlated with cortical thinning, reduced fractional anisotropy, increased mean diffusivity, and correlated with higher UMNB score.
  • No significant changes were detected in [11C]‐PBR28 uptake over 6 months despite clinical progression.
Citation:

Alshikho MJ, Zürcher NR, Loggia ML, et al. Integrated MRI and [11C]‐PBR28 PET imaging in amyotrophic lateral sclerosis. [Published online ahead of print May 8, 2018]. Ann Neurol. doi:10.1002/ana.25251.

This Week's Must Reads

Social Cognitive Theory and Physical Activity in MS, Int J MS Care; 2018 May/June; Uszynski, Casey, et al

Wheeled Mobility Device Intervention Found Feasible, Int J MS Care; 2018 May/June; Rice, Isaacs, et al

Somatic Symptoms of Depression/Anxiety in MS, Int J MS Care; 2018 May/June; Jones, Salem, et al

Turning: Important Marker of Gait and Balance in MS, PLoS One; ePub 2018 Jun 7; Adusumilli, Lancia, et al

Autonomic Dysfunction Compared in Patients with MS, Clin Neurophysiol; 2018 Aug; Adamec, Crnošija, et al

Must Reads in Neuromuscular Disorders

Integrated MRI and [11C]‐PBR28 PET Imaging in ALS, Ann Neurol; ePub 2018 May 8; Alshikho, et al

FDA Approves Hizentra for CIDP Treatment, CSL Behring news release; 2018 Mar 16

FDA Approves Soliris for Generalized MG, Alexion news release; 2017 Oct 23

Immune Changes in ALS Bear Closer Observation, JAMA Neurol; ePub 2017 Sep 25; Murdock, et al

FDA Approves Drug to Treat Duchenne MD, FDA news release; 2017 Feb 9