BSN PSP/CBD Conference – Richard Tsai


Tau PET Imaging in Corticobasal Syndrome

Richard Tsai, MD, UCSF MAC

  • Pet scans are useful in helping identify the underlying pathologic protein in dementia
  • Inject a tracer that can track different proteins in your brain (attaches, gives off a signal, and you can see where that signal is in your brain)
  • B-amyloid PET imaging has altered the diagnostic and clinical trials landscape in Alzheimer’s
  • More and more new investigational drugs are targeting tau.
  • F-AV-1451 development in Alzheimer’s
    • Initially developed to study tau in Alzheimer’s
    • Actually working well in identifying location and severity of Alzheimer’s disease tau
    • The tau protein in CBD is different than Alzheimer’s tau
    • Hard to predict what the underlying pathology is in CBD
      • Can be associated with CBD, PSP, AD, TDP-42, and a mix of the above
  • F-AV-1451 in Corticobasal syndrome
    • 3 Different types coming up
      • Different levels of protein build up
      • Took all the scans for CBD patients, about half have PSP/tau pathology
    • Can a tau pet measure how severe your disease is?
      • Signal strength correlates with motor symptoms severity
    • Does FAV1451 actually bind to CBD-tau?
      • Not sure yet, but there have only been two patient studies
      • Areas with high populations of tau seen in the autopsy are often associated with areas associated with CBS/CBD
    • Trouble with nonspecific binding – not exactly sure what it’s binding to, so we can’t be sure that it is 100% accurate. There are a lot of nonspecific signals in neurodegenerative syndromes that are not expected to have tau
      • More work needs to be done…
      • More imaging needed in autopsy cases to be sure