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Background: There is a need for faster amyloid PET scans to reduce patients' discomfort, minimize movement artifacts, and increase throughput. The recently introduced uMI Panorama PET/CT system featuring enhanced spatial resolution and sub-200ps TOF offers the potential for shorter scan duration without sacrificing image quality or efficacy to detect Aβ deposition. The study aims to establish a faster acquisition protocol for [18F]florbetapir PET imaging using digital PET/CT scanner uMI Panorama, while ensuring adequate image quality and amyloid-β (Aβ) detectability comparable to the standard 10-minute scan. Methods: Thirty-eight participants (29 Aβ positive and 9 Aβ negative) from a prospective dementia cohort at Peking Union Medical University Hospital underwent routine [18F]florbetapir PET scans using the uMI Panorama PET/CT scanner and a T1-weighted brain MRI scan. List-mode PET data were reconstructed into durations of 10 min, 2 min, 1 min, 45 s, and 30 s (G10min, G2min, G1min, G45s, G30s). Two trained nuclear medicine physicians independently evaluated the image quality using a 5-point scale and provided binary diagnosis. Standardized uptake value ratios (SUVr) of the composite cortex (frontal, lateral parietal, lateral temporal, and cingulate cortices) were calculated to discriminate Aβ status and coefficient of variation assessed objective image quality. Comparisons of image quality and Aβ detectability between various fast scan groups and G10min group were conducted. Results: The subjective image quality evaluation and Aβ detectability results from the two physicians showed both good intra-reader and inter-reader agreements (Cohen's kappa coefficient: 0.759-1.000). The subjective and objective image qualities of the G2min scans were comparable to the G10min scans, whereas adequate image quality was achieved with the G1min and G45s scans (5-point score ≥ 3). Subjective visual diagnosis by two physicians yielded consistent accuracy for G10min, G2min, and G1min groups, but lower specificity for G45s and G30s groups. The objective detection of Aβ status by cortex SUVr across all scan durations maintained perfect discriminatory efficiency and relatively high effect size (Hedge's G: 2.48–2.54). Conclusions: A 1-min ultra-fast scan is feasible for [18F]florbetapir PET imaging using uMI Panorama PET/CT, while maintaining adequate image quality and Aβ diagnostic efficiency. Clinical trial registration: NCT05023564. Registered September 2022 https://clinicaltrials.gov/search?term=NCT05023564. [ABSTRACT FROM AUTHOR]

Purpose: Syphilis, caused by Treponema pallidum, presents a diagnostic challenge due to its diverse clinical manifestations. Neurosyphilis has seen a resurgence in recent years, particularly among men who have sex with men and those living with HIV. Diagnosis of neurosyphilis in emergency settings is challenging due to its varied neurological presentations. This study aims to serve as a reference for dermatologists and neurologists in diagnosing and treating neurosyphilis. Patients and Methods: This retrospective study analyzed patients who presented with neuropsychiatric symptoms and were ultimately diagnosed with neurosyphilis. These patients were collected from the emergency department in Peking Union Medical College Hospital between January 2018 and November 2023. The medical history, clinical symptoms, laboratory examinations, cranial MRI characteristics, and treatment regimens of these patients were investigated. Results: Among the included 12 neurosyphilis patients, memory deterioration was observed in 8 out of the 12 neurosyphilis patients. Diagnosis often resulted in delays, with misdiagnoses mainly including Alzheimer's disease, stroke, and epilepsy. Neuroimaging revealed various abnormalities, predominantly affecting ventricular and temporal regions. Treatment with penicillin-based regimens varied in compliance, with only a minority of patients adhering to guidelines. Treatment outcomes were inconsistent, with some patients experiencing irreversible neurological damage and fluctuating serum rapid plasma reagin (RPR) titers. Conclusion: Diagnosis of neurosyphilis in the emergency department remains challenging, necessitating awareness of its varied neurological presentations. Enhanced diagnostic strategies are imperative to accelerate treatment initiation and improve outcomes for affected individuals. [ABSTRACT FROM AUTHOR]

Background: Previous studies on APOE have mostly focused on APOE ε4, while less attention has been paid to APOE ε2. The aim of this study was to clarify the effect of APOE ε2 on different cognitive domains in dementia patients. Method: All subjects were from the Peking Union Medical College Hospital (PUMCH) dementia cohort and included clinical diagnoses of AD, VaD, FTLD, and LBD. All included individuals had completed the neuropsychological assessment. Genotypes were used to bin participants into five groups based on carrier status: ε2 carriers (ε2/ε2 or ε2/ε3), ε2/ε4 carriers, ε3/ε3 carriers, ε3/ε4 carriers, and ε4/ε4 carriers. The effect of APOE ε2 on different cognitive domains of the patients with dementia was assessed by using multivariate regression models. Result: A total of 348 dementia patients were included in this study, with a mean age of 68.4± 9.8 years, 69.3% with AD, 14.4% with VaD, 10.1% with FTLD, and 6.3% with DLB. 19.5% were ε2 carriers, 3.4% were ε2/ε4 carriers, 30.7% were ε3/ε3 carriers, 32.3% were ε3/ε4 carriers, and 14.1% were ε4/ε4 carriers. Compared to ε3/ε3 carriers, ε2 carriers were more successful in MOCA (β = 1.93, P = 0.016), trail making test part A (β = 1.18, P = 0.025), nonverbal memory (β = 1.08, P = 0.003), AVLT 5 (β = 0.27, P = 0.039), episodic memory (β = 0.41, P = 0.005), calculation (β = 1.05, P = 0.045) and word fluency (β = 1.82, P = 0.03). Compared to ε4/ε4 carriers, ε2 carriers performed better in nonverbal memory (β = 1.59, P<0.001), AVLT 4 (β = 0.68, P<0.001), AVLT 5 (β = 0.62, P<0.001), associative learning test (β = 0.57, P<0.001), episodic memory (β = 0.46, P = 0.007) performed better. When adjusted for clinical diagnosis, the above significant differences remained statistically significant. While ε2/ε4 carriers performed better in associative learning (β = 1.38, P<0.001) compared to ε3/ε3, visuospatial (β = ‐1.94, P = 0.020) function was worse than ε3/ε3 carriers. Compared to ε4/ε4, ε2/ε4 carriers performed worse in similarity test and visuospatial function, while in verbal memory performed better Conclusion: The present study found complex effects of APOE ε2 and APOE ε2/ε4 on cognitive domains that varied according to the selected control group, whereas different clinical diagnoses did not seem to influence their effects. [ABSTRACT FROM AUTHOR]

Background: METHODS: The GRN mutations, especially of the loss of function type, are causative of frontotemporal dementia (FTD). However, several GRN variants can be found in other neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease. So far, there have been over 300 GRN mutations reported globally. However, the genetic spectrum and phenotypic characteristics have not been fully elucidated in Chinese population.The participants were from the dementia cohort of Peking Union Medical College Hospital (n=1945). They received history inquiry, cognitive evaluation, brain imaging and exome sequencing. The dementia subjects carrying the rare variants of the GRN were included in this study. Those with the pathogenic or likely pathogenic variants of other dementia-related genes were excluded., Results: 14 subjects carried the rare variants of GRN . They were clinically diagnosed with behavioural variant of FTD (n=2), non-fluent/agrammatic variant primary progressive aphasia (PPA, n=3), semantic variant PPA (n=1), AD (n=6) and mixed dementia (n=2). 13 rare variants of GRN were found, including 6 novel variants (W49X, S226G, M152I, A91E, G79E and A303S). The most prevalent symptom was amnesia (85.7%, 12/14), followed by psychiatric and behavioural disorder (78.6%, 11/14). In terms of lobar atrophy, temporal atrophy/hypometabolism was the most common (85.7%, 12/14), followed by parietal atrophy/hypometabolism (78.6%, 11/14)., Conclusion: The novel GRN variants identified in this study contribute to enrich the GRN mutation repertoire. There is phenotypic similarity and diversity among Chinese patients with the GRN mutations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)