DOI: 10.1007/s00259-018-4075-3Pages: 2342-2357

Distinct [18F]THK5351 binding patterns in primary progressive aphasia variants

1. KU Leuven, Laboratory for Cognitive Neurology, Department of Neurosciences

2. KU Leuven, Alzheimer Research Centre KU Leuven, Leuven Research Institute for Neuroscience & Disease

3. KU Leuven, Laboratory of Radiopharmaceutical Research

4. University Hospitals Leuven, Nuclear Medicine and Molecular Imaging

5. University Hospitals Leuven, Neurology Department

6. Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB

7. University of Antwerp, Institute Born-Bunge, Neuropathology and Laboratory of Neurochemistry and Behavior

8. University Hospital Ghent, Neurology Department

9. GGZinGeest, Old Age Psychiatry Department

10. VU University Medical Center, Alzheimer Center & Department of Neurology

11. University Hospitals Leuven, Radiology Department

Correspondence to:
Rik Vandenberghe
Tel: +3216344280




To assess the binding of the PET tracer [18F]THK5351 in patients with different primary progressive aphasia (PPA) variants and its correlation with clinical deficits. The majority of patients with nonfluent variant (NFV) and logopenic variant (LV) PPA have underlying tauopathy of the frontotemporal lobar or Alzheimer disease type, respectively, while patients with the semantic variant (SV) have predominantly transactive response DNA binding protein 43-kDa pathology.


The study included 20 PPA patients consecutively recruited through a memory clinic (12 NFV, 5 SV, 3 LV), and 20 healthy controls. All participants received an extensive neurolinguistic assessment, magnetic resonance imaging and amyloid biomarker tests. [18F]THK5351 binding patterns were assessed on standardized uptake value ratio (SUVR) images with the cerebellar grey matter as the reference using statistical parametric mapping. Whole-brain voxel-wise regression analysis was performed to evaluate the association between [18F]THK5351 SUVR images and neurolinguistic scores. Analyses were performed with and without partial volume correction.


Patients with NFV showed increased binding in the supplementary motor area, left premotor cortex, thalamus, basal ganglia and midbrain compared with controls and patients with SV. Patients with SV had increased binding in the temporal lobes bilaterally and in the right ventromedial frontal cortex compared with controls and patients with NFV. The whole-brain voxel-wise regression analysis revealed a correlation between agrammatism and motor speech impairment, and [18F]THK5351 binding in the left supplementary motor area and left postcentral gyrus. Analysis of [18F]THK5351 scans without partial volume correction revealed similar results.


[18F]THK5351 imaging shows a topography closely matching the anatomical distribution of predicted underlying pathology characteristic of NFV and SV PPA. [18F]THK5351 binding correlates with the severity of clinical impairment.

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  • Accepted: Jun 12, 2018
  • Online: Jun 26, 2018

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