Patterns of glucose hypometabolism in Down syndrome resemble sporadic Alzheimer's disease except for the putamen

Alzheimers Dement (Amst). 2021 Jan 13;12(1):e12138. doi: 10.1002/dad2.12138. eCollection 2020.

Abstract

Introduction: Adults with Down syndrome (DS) are predisposed to Alzheimer's disease (AD) and the relationship between cognition and glucose metabolism in this population has yet to be evaluated.

Methods: Adults with DS (N = 90; mean age [standard deviation] = 38.0 [8.30] years) underwent [C-11]Pittsburgh compound B (PiB) and [F-18]fluorodeoxyglucose (FDG) positron emission tomography scans. Associations among amyloid beta (Aβ), FDG, and measures of cognition were explored. Interregional FDG metabolic connectivity was assessed to compare cognitively stable DS and mild cognitive impairment/AD (MCI-DS/AD).

Results: Negative associations between Aβ and FDG were evident in regions affected in sporadic AD. A positive association was observed in the putamen, which is the brain region showing the earliest increases in Aβ deposition. Both Aβ and FDG were associated with measures of cognition, and metabolic connectivity distinguished cases of MCI-DS/AD from cognitively stable DS.

Discussion: Associations among Aβ, FDG, and cognition reveal that neurodegeneration in DS resembles sporadic AD with the exception of the putamen, highlighting the usefulness of FDG in monitoring neurodegeneration in DS.

Keywords: Alzheimer's disease; Down syndrome; amyloid positron emission tomography; cognitive decline; fluorodeoxyglucose; individual metabolic brain network.