Regional glucose metabolic abnormalities are not the result of atrophy in Alzheimer's disease
Regional glucose metabolic abnormalities are not the result of atrophy in Alzheimer's disease
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DOI：
10.1212/wnl.50.6.1585
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发表时间：
1998-06-01
期刊：
影响因子：
9.9
通讯作者：
Horwitz, B
中科院分区：
文献类型：
--
作者：
Ibáñez, V;Pietrini, P;Horwitz, B
目的：确定阿尔茨海默病（AD）患者PET图像中观察到的低代谢是否完全是由于脑萎缩所致。背景：许多作者报道了使用PET测量AD患者脑葡萄糖代谢降低。由于脑萎缩，AD患者的实际葡萄糖代谢值可能被人为降低，这加重了PET收集数据的部分容积效应（PVE）。研究方法：使用分段的MR图像，我们校正了PVE的葡萄糖局部脑代谢率，以评估AD患者和健康对照受试者脑代谢未校正值的萎缩效应。结果：与对照组相比，AD患者在矫正前后的总体糖代谢显著降低。在PVE校正前，患者的下顶叶、额叶和外侧颞叶皮质、后扣带回和楔前叶的葡萄糖代谢值低于对照组。PVE校正后，这些降低仍然显着降低，虽然在后扣带回的AD患者和对照组之间的代谢差异减少。PVE校正后，中重度痴呆患者的这些区域的局部葡萄糖代谢低于轻度痴呆患者。结论：在AD中通过PET测量的葡萄糖代谢降低不仅仅是由于萎缩诱导的CSF空间增加所致的伪影，而是反映了每克组织的真实代谢降低。
Objective: To determine whether the hypometabolism observed in PET images of patients with Alzheimer's disease (AD) is due entirely to brain atrophy. Background: Reduced brain glucose metabolism in AD patients measured using PET has been reported by numerous authors. Actual glucose metabolic values in AD may be reduced artificially because of brain atrophy, which accentuates the partial volume effect (PVE) on data collected by PET. Methods: Using segmented MR images, we corrected regional cerebral metabolic rates for glucose for PVEs to evaluate the effect of atrophy on uncorrected values for brain metabolism in AD patients and healthy control subjects. Results: Global glucose metabolism was reduced significantly before and after correction in AD patients compared with controls. Before PVE correction, glucose metabolic values in patients were lower than in control subjects in the inferior parietal, frontal, and lateral temporal cortex; in the posterior cingulate; and in the precuneus. These reductions remained significantly lower after PVE correction, although in the posterior cingulate the difference in metabolism between AD patients and control subjects lessened. Regional glucose metabolism of these areas with PVE correction was lower in moderately-severely demented patients than in mildly demented patients. Conclusion: Reduced glucose metabolism measured by PET in AD is not simply an artifact due to an increase in CSF space induced by atrophy, but reflects a true metabolic reduction per gram of tissue.