Cerebral metabolic changes accompanying conversion of mild cognitive impairment into Alzheimer's disease: a PET follow-up study
Cerebral metabolic changes accompanying conversion of mild cognitive impairment into Alzheimer's disease: a PET follow-up study
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DOI：
10.1007/s00259-003-1194-1
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发表时间：
2003-08-01
影响因子：
9.1
通讯作者：
Kurz, A
中科院分区：
文献类型：
--
作者：
Drzezga, A;Lautenschlager, N;Kurz, A
轻度认知障碍(MCI)患者在1年内发展为阿尔茨海默型(AD)临床痴呆的比例很高。这项纵向研究的目的是确定从MCI转变为AD的患者基线时大脑代谢的特征模式，并评估这些模式随时间的变化。对22例MCI患者(男12例，女10例，年龄69.8+/-5.8岁)进行基线检查和1年后随访，检查内容包括神经心理测试、结构头颅磁共振成像和18F脱氧葡萄糖正电子发射断层扫描(PET)评估相对脑葡萄糖代谢率(RCMRglc)。使用NeUROSTAT软件(Univ.美国安娜堡密歇根州)。随后，使用SPM 99对PET数据与年龄匹配的健康对照人群以及患者亚组之间的数据进行统计比较。神经影像科学，伦敦，英国)。1年后，8名患者(36%)发展为可能的AD(称为MCIAD)，而12名(55%)仍被归类为具有稳定的MCI(称为MCIMCI)。与健康对照组相比，MCIAD患者的典型AD区域，包括顶叶皮质和扣带回后部的rCMRglc在基线时被检测到降低。与MCIMCI组相比，后扣带回皮质的异常也达到显著水平。一年后，MCIAD患者表现出额叶前区rCMRglc额外的双侧减少，以及顶叶和后扣带皮质异常的进一步进展。在MCIMCI组没有观察到这样的变化。在MCI患者中，特征性的大脑代谢差异可以在最初出现时被描绘出来，这有助于确定预后亚组。前额叶皮质rCMRglc的新出现降低与MCI向AD的转变有关。
A high percentage of patients with mild cognitive impairment (MCI) develop clinical dementia of the Alzheimer type (AD) within 1 year. The aim of this longitudinal study was to identify characteristic patterns of cerebral metabolism at baseline in patients converting from MCI to AD, and to evaluate the changes in these patterns over time. Baseline and follow-up examinations after 1 year were performed in 22 MCI patients (12 males, 10 females, aged 69.8+/-5.8 years); these examinations included neuropsychological testing, structural cranial magnetic resonance imaging and fluorine-18 fluorodeoxyglucose positron emission tomography (PET) evaluation of relative cerebral glucose metabolic rate (rCMRglc). Individual PET scans were stereotactically normalised with NEUROSTAT software (Univ. of Michigan, Ann Arbor, USA). Subsequently, statistical comparison of PET data with an age-matched healthy control population and between patient subgroups was performed using SPM 99 (Wellcome Dept. of Neuroimaging Sciences, London, UK). After 1 year, eight patients (36%) had developed probable AD (referred to as MCIAD), whereas 12 (55%) were still classified as having stable MCI (referred to as MCIMCI). Compared with the healthy control group, a reduced rCMRglc in AD-typical regions, including the temporoparietal and posterior cingulate cortex, was detected at baseline in patients with MCIAD. Abnormalities in the posterior cingulate cortex reached significance even in comparison with the MCIMCI group. After 1 year, MCIAD patients demonstrated an additional bilateral reduction of rCMRglc in prefrontal areas, along with a further progression of the abnormalities in the parietal and posterior cingulate cortex. No such changes were observed in the MCIMCI group. In patients with MCI, characteristic cerebral metabolic differences can be delineated at the time of initial presentation, which helps to define prognostic subgroups. A newly emerging reduction of rCMRglc in prefrontal cortical areas is associated with the transition from MCI to AD.