Glucose metabolism in early onset versus late onset Alzheimer's disease: an SPM analysis of 120 patients
Glucose metabolism in early onset versus late onset Alzheimer's disease: an SPM analysis of 120 patients
复制标题
DOI：
10.1093/brain/awh539
复制
发表时间：
2005-08-01
期刊：
影响因子：
14.5
通讯作者：
Na, DL
中科院分区：
文献类型：
--
作者：
Kim, EJ;Cho, SS;Na, DL
这项横断面研究的目的是(I)在大样本患者中比较早发性和晚发性阿尔茨海默病患者之间的整体糖代谢；以及(Ii)使用统计参数图(SPM)分析，研究早发性阿尔茨海默病和晚发性阿尔茨海默病患者的糖代谢模式作为痴呆严重程度的函数。受试者包括四组：74例早发性阿尔茨海默病患者，46例迟发性阿尔茨海默病患者，以及两组年龄与每个患者组相匹配的对照组。所有受试者在相同的扫描条件下接受2-[F-18]氟-2-脱氧-d-葡萄糖(FDG)-PET检查。用临床痴呆量表(CDR)评定痴呆的严重程度。使用基于体素的SPM99进行统计分析。早发性阿尔茨海默病患者的总体葡萄糖低代谢在幅度和程度上比晚发性患者大得多，尽管两组在痴呆症严重程度上相似：早发组在顶叶、额叶和皮质下(基底节和丘脑)表现出更严重的低代谢。当将糖代谢下降作为CDR分期的函数进行比较时，早发性阿尔茨海默病的斜率比晚发性阿尔茨海默病的斜率更大。早发组CDR0.5-1出现快速下降，晚发组CDR2-3出现类似变化。早发的患者比晚发的患者需要更大的低代谢才能达到相同的痴呆症严重程度，这可能反映了年轻患者比年长患者更多的功能储备。另一种情况是，代谢下降曲线表明，早发患者的糖代谢下降过程可能比晚发患者更快。
The aims of this cross-sectional study were (i) to compare the overall glucose metabolism between early onset and late onset Alzheimer's disease in a large sample of patients; and (ii) to investigate the pattern of glucose metabolism as a function of dementia severity in early onset versus late onset Alzheimer's disease, using a statistical parametric mapping (SPM) analysis. Subjects consisted of four groups: 74 patients with early onset Alzheimer's disease, 46 patients with late onset of the disease, and two control groups age matched to each patient group. All the subjects underwent 2-[F-18]fluoro-2-deoxy-d-glucose (FDG)-PET under the same scanning conditions. Severity of dementia was rated with the Clincial Dementia Rating (CDR). Voxel-based SPM99 was used for statistical analyses. Overall glucose hypometabolism of early onset Alzheimer's disease patients was much greater in magnitude and extent than that of late onset patients, though both groups were similar in dementia severity: the early onset group showed more severe hypometabolism in parietal, frontal and subcortical (basal ganglia and thalamus) areas. When the decline of glucose metabolism was compared as a function of CDR stage, the slope was steeper in early onset than in late onset Alzheimer's disease. The rapid decline occurred at CDR 0.5-1 in the early onset group, whereas similar changes occurred at CDR 2-3 in the late onset group. The greater hypometabolism in early onset than in late onset patients is required to reach the same severity of dementia, probably reflecting greater functional reserve in younger than in older subjects. Alternatively, the metabolic decline curve suggests that the early onset patients may take a more rapid course in the reduction of glucose metabolism than the late onset patients.