News | PET Imaging | July 16, 2020

SNMMI Image of the Year Features Super-agers

Super-agers show resistance to tau and amyloid accumulation

Tau (blue) and amyloid (orange) distribution patterns for super-agers, normal-agers and MCI patients, when compared to a group of younger, healthy, cognitively normal, amyloid-negative individuals. Brain projections are depicted at an uncorrected significance level of p < .0001. Color bars represent the respective t-statistic. Image courtesy of Merle C. Hoenig, Institute for Neuroscience and Medicine II - Molecular Organization of the Brain, Research Center Juelich, Juelich, Germany, and Department of Nucle

Tau (blue) and amyloid (orange) distribution patterns for super-agers, normal-agers and MCI patients, when compared to a group of younger, healthy, cognitively normal, amyloid-negative individuals. Brain projections are depicted at an uncorrected significance level of p < .0001. Color bars represent the respective t-statistic. Image courtesy of Merle C. Hoenig, Institute for Neuroscience and Medicine II - Molecular Organization of the Brain, Research Center Juelich, Juelich, Germany, and Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.

July 16, 2020 — Super-agers, or individuals whose cognitive skills are above the norm even at an advanced age, have been found to have increased resistance to tau and amyloid proteins, according to research presented at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2020 Annual Meeting. An analysis of positron emission tomography (PET) scans has shown that compared to normal-agers and those with mild cognitive impairment, super-agers have a lower burden of tau and amyloid pathology associated with neurodegeneration, which probably allows them to maintain their cognitive performance. An image showing the comparison of tau and amyloid distribution patterns in these different cognitive aging trajectories has been selected as SNMMI's 2020 Image of the Year.

"Our cognition reflects who we are as individuals. As we age, most of us lose some of that ability," said SNMMI's Scientific Program Committee chair, Umar Mahmood, M.D., Ph.D. "The Image of the Year provides us with insight into how we can use these PET imaging biomarkers to understand behaviors and therapies that may allow more of us age better and retain more of our cognitive abilities as we get older."

Each year, SNMMI chooses an image that best exemplifies the most promising advances in the field of nuclear medicine and molecular imaging. The state-of-the-art technologies captured in these images demonstrate the capacity to improve patient care by detecting disease, aiding diagnosis, improving clinical confidence and providing a means of selecting appropriate treatments. This year, the SNMMI Henry N. Wagner, Jr., M.D., Image of the Year was chosen from more than two thousand abstracts submitted to the meeting and voted on by reviewers and the society leadership.

"The phenomenon of super-aging suggests that cognitively high-functioning individuals have extraordinary mechanisms that resist brain aging processes and neurodegeneration," said Merle Hoenig, M.D., Research Center Juelich & University Hospital Cologne, Germany. Some insights have been collected on amyloid pathology in super-agers, but there is no in vivo evidence on tau pathology due to the former lack of available imaging techniques. "We know that tau pathology is more closely associated with cognitive decline than amyloid pathology," Hoenig continued, "thus, the resistance, in particular against tau pathology, likely allows these individuals to perform cognitively above average even at advanced age."

Data from the Alzheimer's Disease Neuroimaging Initiative was utilized to create three age- and education-matched groups of 25 super-agers, 25 normal-agers and 25 patients with mild cognitive impairment, all above 80 years old. In addition, 18 younger, cognitively normal, amyloid-negative controls were included in the comparison as a reference group. 18F-AV-1451 and 18F-AV-45 PET images obtained for all individuals and researchers compared the tau and amyloid burden between the four groups. A logistic regression was performed to identify genetic and pathophysiological factors best predicting aging processes.

No significant differences between super-agers and the younger control group were observed in terms of in vivo tau and amyloid burden. The normal-ager group exhibited tau burden in inferior temporal and precuneal areas and no significant differences in amyloid burden, when compared to the younger control group. Patients with mild cognitive impairment showed both high amyloid and high tau pathology burden. Differences in amyloid burden dissociated the normal-agers from those with mild cognitive impairment, whereas lower tau burden and lower polygenic risk predicted super-agers from mild cognitive impairment patients.

"While super-agers may be able to resist aging-associated proteinopathies, in particular tau pathology, normal-agers may not and are thus exposed to inevitable cognitive decline due to the accumulation of neurotoxic tau tangles and the advancing aging process," noted Hoenig. "Moving further to the other extreme of aging, namely mild cognitive impairment, the synergistic effects of both amyloid and tau may accelerate the pathological aging process."

These results motivate further research to determine responsible resistance factors, which may also inspire the development of novel treatment concepts. "Given the multitude of factors involved in the aging process, it will certainly be challenging to develop therapeutics to tackle the factors involved. However, if we understand which individuals are resistant to dementia, this will help us identify potential pathways that promote successful aging--protecting against not only Alzheimer's disease but also other aging-associated diseases, such as vascular disease and other forms of dementia," said Hoenig.

For more information: www.snmmi.org

Related SNMMI20 Content:

SNMMI Channel

Molecular Imaging Identifies Link Between Heart and Kidney Inflammation After Heart Attack

PSMA PET/CT Can Change Management in Recurrent Prostate Cancer

Total-body Dynamic PET Successfully Detects Metastatic Cancer

New PET Radiotracer Proven Safe in Imaging Malignant Brain Tumors

Targeted Radionuclide Therapy Enhances Prostate Cancer Response to Immunotherapies

New PET/MRI Approach Pinpoints Chronic Pain Location, Alters Management

Related Content

#NorthStar Medical #Radioisotopes, LLC, a global innovator in the development, production and commercialization of #radiopharmaceuticals used for #medicalimaging and #therapeutic applications, announced a corporate update highlighting progress across its key programs during the past twelve months and upcoming milestones.

NorthStar Medical Radioisotopes, Beloit, Wisconsin campus (Photo: Business Wire)

News | Radiopharmaceuticals and Tracers | April 16, 2021
April 16, 2021 — ...
Shine executives are joined by the company’s construction managers and partners at its medical isotope production facility. The group was commemorating the facility’s achievement of weathertight status

Shine executives are joined by the company’s construction managers and partners at its medical isotope production facility. The group was commemorating the facility’s achievement of weathertight status. Image courtesy of Shine Medical Technologies

News | Radiopharmaceuticals and Tracers | March 26, 2021
March 26, 2021 — Shine Medical Technologies LLC announced that construction of the exterior structure of its first-of
The phantom used for hyperpolarized imaging, with an illustration of imaging slices acquired using the new technique. photo/©: Laurynas Dagys, University of Southampton

The phantom used for hyperpolarized imaging, with an illustration of imaging slices acquired using the new technique. photo/©: Laurynas Dagys, University of Southampton

News | Nuclear Imaging | March 12, 2021
March 12, 2021 — Magnetic resonance imaging (MRI)
Diagnostic imaging studies using Tc-99m inform healthcare decisions for approximately 30 million patients annually around the world
News | Nuclear Imaging | March 08, 2021
March 8, 2021 — IBA (Ion Beam Applications S.A., EURONEXT) an
Axial fused PET/CT image shows intense uptake (arrowhead) in the deep pelvis corresponding to the left lobe of the prostate in a 62-year-old with a history of prostate cancer treated with radiation therapy.  The CT scan does not show the tumor. Image courtesy of the the Radiological Society of North America.

Axial fused PET/CT image shows intense uptake (arrowhead) in the deep pelvis corresponding to the left lobe of the prostate in a 62-year-old with a history of prostate cancer treated with radiation therapy. The CT scan does not show the tumor. Image courtesy of the the Radiological Society of North America.

Feature | Treatment Planning | March 05, 2021 | By Melinda Taschetta-Millane
The decision to offer...
CT imaging radiation dose tracking software from Imalogix displayed at RSNA 2019.

CT imaging radiation dose tracking software from Imalogix displayed at RSNA 2019. Photo by Dave Fornell.

Feature | Radiation Dose Management | March 04, 2021 | By Dave Fornell
More than a decade ago, there was an alarming, rapid rise in ionizing radiation exposure in the U.S.
Findings indicate that PPC and GG are highly predictive of overall upstaging by PSMA PET/CT for patients with high-risk prostate cancer

Image courtesy of UCLA Health

News | PET-CT | February 23, 2021
February 23, 2021 — A...
F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.

F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.

News | Molecular Imaging | February 22, 2021
February 22, 2021 — Molecular imaging