Assessment of 18F-PI-2620 as a Biomarker in Progressive Supranuclear Palsy

Matthias Brendel, H. Barthel, T. van Eimeren, K. Marek, L. Beyer, M. Song; C. Palleis, M. Gehmeyr; U. Fietzek, G. Respondek, J. Sauerbeck; A. Nitschmann; C. Zach, J. Hammes, M. T. Barbe, O. Onur, F. Jessen, D. Saur, M. L. Schroeter, J.-J. Rumpf, M. Rullmann, A. Schildan, M. Patt, B. Neumaier, O. Barret, J. Madonia, D. S. Russell, A. Stephens, S. Roeber, J. Herms, K. Botzel, J. Classen, P. Bartenstein, V. Villemagne, J. Levin, G. U. Hoglinger, A. Drzezga, J. Seibyl, O. Sabri

JAMA Neurol. doi:10.1001/jamaneurol.2020.2526 

Published online July 7, 2020.

Selezionato dal Lettore: Pietro Falco - Università degli Studi La Sapienza - Roma

MOTIVATION: In this multicentric cross-sectional study, the Authors assessed the performance of the new radiotracer of 4R-tau (18F-PI-2620) to diagnose Progressive Supranuclear Palsy (PSP). Currently, definite PSP is a neuropathological diagnosis, whereas in clinical practice the diagnosis of probable PSP is supported by imaging data, such as mesencephalic hypotrophy at brain-MRI or hypometabolism at FDG-PET. However, these changes occur late in disease course. The validation of tau-PET as a new diagnostic tool will allow at discriminating PSP patients in an early stage. 

The Authors have investigated 60 PSP patients by tau-PET and compared findings with those from 10 healthy controls and 20 patients with Parkinson disease or Multiple System Atrophy. They found a significant binding of 4R-tau to PSP target regions that discriminated PSP patients from healthy and disease controls with 85% sensitivity and 77% specificity, respectively. Post-mortem brain tissue analysis of 4 PSP patients and 4 healthy controls by in vitro autoradiography showed blockable 18F-PI-2620 binding in PSP patients alone.

These findings suggest that the new diagnostic tool could significantly improve the diagnosis in clinical practice and provide innovative measures for disease-modifying clinical trials in PSP.