• Han Kyu Na, Jeong-Hyeon Shin, Sung-Woo Kim, Seongho Seo, Woo-Ram Kim, Jae Myeong Kang, Sang-Yoon Lee, Jaelim Cho, Justin Byun, Nobuyuki Okamura, Joon-Kyung Seong, and Young Noh.
• Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
• Yonsei Med. J. 2024 Aug 1; 65 (8): 434447434-447.

PurposeAlzheimer's disease (AD) dementia may not be a single disease entity. Early-onset AD (EOAD) and late-onset AD (LOAD) have been united under the same eponym of AD until now, but disentangling the heterogeneity according to the age of sonset has been a major tenet in the field of AD research.Materials And MethodsNinety-nine patients with AD (EOAD, n=54; LOAD, n=45) and 66 cognitively normal controls completed both [18F]THK5351 and [18F]flutemetamol (FLUTE) positron emission tomography scans along with structural magnetic resonance imaging and detailed neuropsychological tests.ResultsEOAD patients had higher THK retention in the precuneus, parietal, and frontal lobe, while LOAD patients had higher THK retention in the medial temporal lobe. Intravoxel correlation analyses revealed that EOAD presented narrower territory of local FLUTE-THK correlation, while LOAD presented broader territory of correlation extending to overall parieto-occipito-temporal regions. EOAD patients had broader brain areas which showed significant negative correlations between cortical thickness and THK retention, whereas in LOAD, only limited brain areas showed significant correlation with THK retention. In EOAD, most of the cognitive test results were correlated with THK retention. However, a few cognitive test results were correlated with THK retention in LOAD.ConclusionLOAD seemed to show gradual increase in tau and amyloid, and those two pathologies have association to each other. On the other hand, in EOAD, tau and amyloid may develop more abruptly and independently. These findings suggest LOAD and EOAD may have different courses of pathomechanism.© Copyright: Yonsei University College of Medicine 2024.

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