Testing the diagnostic accuracy of [18F]FDG-PET in discriminating spinal- and bulbar-onset amyotrophic lateral sclerosis.

PURPOSE: The role for [18F]FDG-PET in supporting amyotrophic lateral sclerosis (ALS) diagnosis is not fully established. In this study, we aim at evaluating [18F]FDG-PET hypo- and hyper-metabolism patterns in spinal- and bulbar-onset ALS cases, at the single-subject level, testing the diagnostic value in discriminating the two conditions, and the correlations with core clinical symptoms severity. METHODS: We included 95 probable-ALS patients with [18F]FDG-PET scan and clinical follow-up. [18F]FDG-PET images were analyzed with an optimized voxel-based-SPM method. The resulting single-subject SPM-t maps were used to: (a) assess brain regional hypo- and hyper-metabolism; (b) evaluate the accuracy of regional hypo- and hyper metabolism in discriminating spinal vs. bulbar-onset ALS; (c) perform correlation analysis with motor symptoms severity, as measured by ALS-FRS-R. RESULTS: Primary motor cortex showed the most frequent hypo-metabolism in both spinal-onset (∼57%) and bulbar-onset (∼64%) ALS; hyper-metabolism was prevalent in the cerebellum in both spinal-onset (∼56.5%) and bulbar-onset (∼55.7%) ALS, and in the occipital cortex in bulbar-onset (∼62.5%) ALS. Regional hypo- and hyper-metabolism yielded a very low accuracy (AUC < 0.63) in discriminating spinal- vs. bulbar-onset ALS, as obtained from single-subject SPM-t-maps. Severity of motor symptoms correlated with hypo-metabolism in sensorimotor cortex in spinal-onset ALS, and with cerebellar hyper-metabolism in bulbar-onset ALS. CONCLUSIONS: The high variability in regional hypo- and hyper-metabolism patterns, likely reflecting the heterogeneous pathology and clinical phenotypes, limits the diagnostic potential of [18F]FDG-PET in discriminating spinal and bulbar onset patients.

Tisochrysis lutea as a Substrate for Lactic Acid Fermentation: Biochemical Composition, Digestibility, and Functional Properties.

Microalgae, because of their high nutritional value and bioactive molecule content, are interesting candidates for functional foods, including fermented foods, in which the beneficial effects of probiotic bacteria combine with those of biomolecules lying in microalgal biomass. The aim of this work was to evaluate the potential of Tisochrysis lutea F&M-M36 as a substrate for Lactiplantibacillus plantarum ATCC 8014 and to verify fermentation effects on functionality. Bacterium selection among three lactobacilli was based on growth and resistance to in vitro digestion. Microalgal raw biomass and its digested residue were fermented in two matrixes, water and diluted organic medium, and analysed for biochemical composition and antioxidant activity along with their unfermented counterparts. Bacterial survivability to digestion and raw biomass digestibility after fermentation were also evaluated. Fucoxanthin was strongly reduced (>90%) in post-digestion residue, suggesting high bioavailability. Raw biomass in diluted organic medium gave the highest bacterial growth (8.5 logCFU mL-1) and organic acid production (5 mg L-1), while bacterial survivability to digestion (<3%) did not improve. After fermentation, the antioxidant activity of lipophilic extracts increased (>90%). Fermentation appears an interesting process to obtain T. lutea-based functional foods, although further investigations are needed to optimize bacterial growth and fully evaluate its effects on functionality and organoleptic features.