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CC BY-NC-ND 4.0 · World J Nucl Med 2022; 21(04): 267-275
DOI: 10.1055/s-0042-1750013
Original Article

Assessment of Alzheimer's Disease Imaging Biomarkers in World Trade Center Responders with Cognitive Impairment at Midlife

Minos Kritikos
1   Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Ana M. Franceschi
2   Division of Neuroradiology, Department of Radiology, Northwell Health/Donald and Barbara Zucker School of Medicine, Manhasset, New York, United States
,
Paul Vaska
3   Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Sean A. P. Clouston
1   Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Chuan Huang
3   Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
4   Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Michael Salerno
3   Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Yael Deri
5   Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Cheuk Tang
6   Icahn School of Medicine at Mount Sinai, New York, New York, United States
,
Alison Pellecchia
5   Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Stephanie Santiago-Michels
5   Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Mary Sano
7   Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States
,
Evelyn J. Bromet
5   Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
,
Roberto G. Lucchini
8   Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, United States
,
Sam Gandy
7   Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States
9   Department of Neurology, The Barbara and Maurice Deane Center for Wellness and Cognitive Health and the Mount Sinai Center for NFL Neurological Care, Icahn School of Medicine at Mount Sinai, New York, New York, United States
,
Benjamin J. Luft
5   Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
10   Stony Brook World Trade Center Wellness Program, Stony Brook Medicine, Stony Brook, New York, United States
› Author Affiliations Funding Funding to study aging in World Trade Center (WTC) responders was provided by the National Institutes of Health (NIH/NIA: R01 AG049953). Funding for the amyloid imaging study was provided by the Centers for Disease Control and Prevention (CDC/NIOSH: U01 OH011314) while funding for the WTC responder monitoring program was provided by the Centers for Disease Control and Prevention (CDC/NIOSH: 200–2011–39361). The brain imaging program at The Barbara and Maurice Deane Center for Wellness and Cognitive Health and the Mount Sinai Center for NFL Neurological Care acknowledges the support of the Alzheimer's Drug Discovery Foundation. We would like to acknowledge and kindly thank the participants in this study and Ms. Melissa Carr7 for her supervision and coordination of participant recruitment.
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Abstract

Purpose Incidence of early onset neurocognitive dysfunction has been reported in World Trade Center (WTC) responders. Ongoing studies are investigating the underlying etiology, as we are concerned that an underlying risk of neurodegenerative dementia may be occurring because of their stressful and neurotoxic exposures to particulate matter when they responded to the search and rescue efforts on September 11, 2001. The purpose of this study is to report preliminary results from two ongoing positron emission tomography (PET)/magnetic resonance imaging (MRI) imaging studies investigating the presence of Alzheimer's disease (AD) biomarkers, such as β-amyloid, tau, and neurodegeneration, and compare our findings to published norms.

Methods We present findings on 12 WTC responders diagnosed with either cognitive impairment (CI) or mild cognitive impairment (MCI), now at midlife, who underwent PET/MRI brain imaging as part of ongoing studies. Six responders with CI received [18F] florbetaben (FBB) to detect β-amyloidosis and six separate responders with MCI received [18F] flortaucipir (FTP) to detect tauopathy. All 12 responders underwent concomitant MRI scans for gray matter volume analysis of neurodegeneration.

Results PET analysis revealed 50% FBB and 50% of FTP scans were clinically read as positive and that 50% of FTP scans identified as consistent with Braak's stage I or II. Furthermore, one responder identified as centiloid positive for AD. Gray matter volumes from MRI analyses were compared with age/sex-matched norms (Neuroquant), identifying abnormally low cortical volumes in the occipital and temporal lobes, as well as the inferior temporal gyri and the entorhinal cortex.

Conclusion These preliminary results suggest that WTC responders with neurocognitive dysfunction may be at increased risk for a neurodegenerative dementia process as a result of their exposures at September 11, 2001.

Keywords

world trade center responders - mild cognitive impairment - PET/MRI - β-amyloid - tau - neurodegeneration

Ethics

The Institutional Review Board (IRB) of each institution (no.: 983492; no.: 1257148) approved the study protocol which included informed consent.


Data Availability

Data can be made available upon reasonable request to the corresponding author.




Publication History

Article published online:
02 September 2022

© 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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