The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial
Abstract Background The Multidomain Alzheimer Preventive Trial (MAPT) was designed to assess the efficacy of omega-3 fatty acid supplementation, multidomain intervention (MI), or a combination of both on cognition. Although the MAPT study was negative, an effect of MI in maintaining cognitive functi...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Alzheimer’s Research & Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13195-020-00683-6 |
| _version_ | 1828871123726499840 |
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| author | Julien Delrieu Thierry Voisin Laure Saint-Aubert Isabelle Carrie Christelle Cantet Bruno Vellas Pierre Payoux Sandrine Andrieu |
| author_facet | Julien Delrieu Thierry Voisin Laure Saint-Aubert Isabelle Carrie Christelle Cantet Bruno Vellas Pierre Payoux Sandrine Andrieu |
| author_sort | Julien Delrieu |
| collection | DOAJ |
| description | Abstract Background The Multidomain Alzheimer Preventive Trial (MAPT) was designed to assess the efficacy of omega-3 fatty acid supplementation, multidomain intervention (MI), or a combination of both on cognition. Although the MAPT study was negative, an effect of MI in maintaining cognitive functions compared to placebo group was showed in positive amyloid subjects. A FDG PET study (MAPT-NI) was implemented to test the impact of MI on brain glucose metabolism. Methods MAPT-NI was a randomized, controlled parallel-group single-center study, exploring the effect of MI on brain glucose metabolism. Participants were non-demented and had memory complaints, limitation in one instrumental activity of daily living, or slow gait. Participants were randomly assigned (1:1) to “MI group” or “No MI group.” The MI consisted of group sessions focusing on 3 domains: cognitive stimulation, physical activity, nutrition, and a preventive consultation. [18F]FDG PET scans were performed at baseline, 6 months, and 12 months, and cerebral magnetic resonance imaging scans at baseline. The primary objective was to evaluate the MI effect on brain glucose metabolism assessed by [18F]FDG PET imaging at 6 months. The primary outcome was the quantification of regional metabolism rate for glucose in cerebral regions involved early in Alzheimer disease by relative semi-quantitative SUVr (FDG-based AD biomarker). An exploratory voxel-wise analysis was performed to assess the effect of MI on brain glucose metabolism without anatomical hypothesis. Results The intention-to-treat population included 67 subjects (34 in the MI group and 33 in the No MI group. No significant MI effect was observed on primary outcome at 6 months. In the exploratory voxel-wise analysis, we observed a difference in favor of MI group on the change of cerebral glucose metabolism in limbic lobe (right hippocampus, right posterior cingulate, left posterior parahippocampal gyrus) at 6 months. Conclusions MI failed to show an effect on metabolism in FDG-based AD biomarker, but exploratory analysis suggested positive effect on limbic system metabolism. This finding could suggest a delay effect of MI on AD progression. Trial registration ClinicalTrials.gov Identifier, NCT01513252 . |
| first_indexed | 2024-12-13T06:26:26Z |
| format | Article |
| id | doaj.art-bea8f98d57744088b69f04671b229df6 |
| institution | Directory Open Access Journal |
| issn | 1758-9193 |
| language | English |
| last_indexed | 2024-12-13T06:26:26Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Alzheimer’s Research & Therapy |
| spelling | doaj.art-bea8f98d57744088b69f04671b229df62022-12-21T23:56:44ZengBMCAlzheimer’s Research & Therapy1758-91932020-10-0112111110.1186/s13195-020-00683-6The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trialJulien Delrieu0Thierry Voisin1Laure Saint-Aubert2Isabelle Carrie3Christelle Cantet4Bruno Vellas5Pierre Payoux6Sandrine Andrieu7Pôle gériatrie, Cité de la santé, Place Lange - TSA 60033INSERM UMR 1027, Toulouse, France; University of Toulouse IIIToulouse NeuroImaging Center, University of Toulouse III, INSERM, UPSGérontopôle, Department of Geriatrics, Toulouse (University Hospital) CHU, Purpan University HospitalINSERM UMR 1027, Toulouse, France; University of Toulouse IIIINSERM UMR 1027, Toulouse, France; University of Toulouse IIIDepartment of Nuclear Medicine, Toulouse CHU, Purpan University HospitalINSERM UMR 1027, Toulouse, France; University of Toulouse IIIAbstract Background The Multidomain Alzheimer Preventive Trial (MAPT) was designed to assess the efficacy of omega-3 fatty acid supplementation, multidomain intervention (MI), or a combination of both on cognition. Although the MAPT study was negative, an effect of MI in maintaining cognitive functions compared to placebo group was showed in positive amyloid subjects. A FDG PET study (MAPT-NI) was implemented to test the impact of MI on brain glucose metabolism. Methods MAPT-NI was a randomized, controlled parallel-group single-center study, exploring the effect of MI on brain glucose metabolism. Participants were non-demented and had memory complaints, limitation in one instrumental activity of daily living, or slow gait. Participants were randomly assigned (1:1) to “MI group” or “No MI group.” The MI consisted of group sessions focusing on 3 domains: cognitive stimulation, physical activity, nutrition, and a preventive consultation. [18F]FDG PET scans were performed at baseline, 6 months, and 12 months, and cerebral magnetic resonance imaging scans at baseline. The primary objective was to evaluate the MI effect on brain glucose metabolism assessed by [18F]FDG PET imaging at 6 months. The primary outcome was the quantification of regional metabolism rate for glucose in cerebral regions involved early in Alzheimer disease by relative semi-quantitative SUVr (FDG-based AD biomarker). An exploratory voxel-wise analysis was performed to assess the effect of MI on brain glucose metabolism without anatomical hypothesis. Results The intention-to-treat population included 67 subjects (34 in the MI group and 33 in the No MI group. No significant MI effect was observed on primary outcome at 6 months. In the exploratory voxel-wise analysis, we observed a difference in favor of MI group on the change of cerebral glucose metabolism in limbic lobe (right hippocampus, right posterior cingulate, left posterior parahippocampal gyrus) at 6 months. Conclusions MI failed to show an effect on metabolism in FDG-based AD biomarker, but exploratory analysis suggested positive effect on limbic system metabolism. This finding could suggest a delay effect of MI on AD progression. Trial registration ClinicalTrials.gov Identifier, NCT01513252 .http://link.springer.com/article/10.1186/s13195-020-00683-6Clinical trials randomized controlledAll cognitive disorders/dementiaAlzheimer’s diseasePETPrevention |
| spellingShingle | Julien Delrieu Thierry Voisin Laure Saint-Aubert Isabelle Carrie Christelle Cantet Bruno Vellas Pierre Payoux Sandrine Andrieu The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial Alzheimer’s Research & Therapy Clinical trials randomized controlled All cognitive disorders/dementia Alzheimer’s disease PET Prevention |
| title | The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial |
| title_full | The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial |
| title_fullStr | The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial |
| title_full_unstemmed | The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial |
| title_short | The impact of a multi-domain intervention on cerebral glucose metabolism: analysis from the randomized ancillary FDG PET MAPT trial |
| title_sort | impact of a multi domain intervention on cerebral glucose metabolism analysis from the randomized ancillary fdg pet mapt trial |
| topic | Clinical trials randomized controlled All cognitive disorders/dementia Alzheimer’s disease PET Prevention |
| url | http://link.springer.com/article/10.1186/s13195-020-00683-6 |
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