J Clin Neurol.  2020 Apr;16(2):202-214. 10.3988/jcn.2020.16.2.202.

[18F]THK5351 PET Imaging in Patients with Mild Cognitive Impairment

  • 1Neuroscience Research Institute, Gachon University, Incheon, Korea.
  • 2Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
  • 3Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea.
  • 4Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea.
  • 5Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Korea.
  • 6Department of Biomedical Engineering, Korea University, Seoul, Korea.
  • 7Department of Artificial Intelligence, Korea University, Seoul, Korea.
  • 8Tohoku Medical and Pharmaceutical University, Sendai, Japan.
  • 9Department of Molecular Imaging & Therapy, Centre for PET, Austin Health, Melbourne, VIC, Australia.
  • 10Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
  • 11Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 12Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea.
  • 13Department of Health Science and Technology, GAIHST, Gachon University, Incheon, Korea.


Background and Purpose
Mild cognitive impairment (MCI) is a condition with diverse clinical outcomes and subgroups. Here we investigated the topographic distribution of tau in vivo using the positron emission tomography (PET) tracer [18F]THK5351 in MCI subgroups.
This study included 96 participants comprising 38 with amnestic MCI (aMCI), 21 with nonamnestic MCI (naMCI), and 37 with normal cognition (NC) who underwent 3.0-T MRI, [18F]THK5351 PET, and detailed neuropsychological tests. [18F]flutemetamol PET was also performed in 62 participants. The aMCI patients were further divided into three groups: 1) verbal-aMCI, only verbal memory impairment; 2) visual-aMCI, only visual memory impairment; and 3) both-aMCI, both visual and verbal memory impairment. Voxel-wise statistical analysis and region-of-interest -based analyses were performed to evaluate the retention of [18F]THK5351 in the MCI subgroups. Subgroup analysis of amyloid-positive and -negative MCI patients was also performed. Correlations between [18F]THK5351 retention and different neuropsychological tests were evaluated using statistical parametric mapping analyses.
[18F]THK5351 retention in the lateral temporal, mesial temporal, parietal, frontal, posterior cingulate cortices and precuneus was significantly greater in aMCI patients than in NC subjects, whereas it did not differ significantly between naMCI and NC participants. [18F] THK5351 retention was greater in the both-aMCI group than in the verbal-aMCI and visualaMCI groups, and greater in amyloid-positive than amyloid-negative MCI patients. The cognitive function scores were significantly correlated with cortical [18F]THK5351 retention.
[18F]THK5351 PET might be useful for identifying distinct topographic patterns of [18F]THK5351 retention in subgroups of MCI patients who are at greater risk of the progression to Alzheimer's dementia.


mild cognitive impairment; neurofibrillary tangles; positron emission tomography
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