PET amyloid ligand [11C]PIB uptake is increased in mild cognitive impairment
PET amyloid ligand [11C]PIB uptake is increased in mild cognitive impairment
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DOI：
10.1212/01.wnl.0000260969.94695.56
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发表时间：
2007-05-08
期刊：
影响因子：
9.9
通讯作者：
Rinne, J. O.
中科院分区：
文献类型：
--
作者：
Kemppainen, N. M.;Aalto, S.;Rinne, J. O.
背景：轻度认知障碍（MCI）患者患阿尔茨海默病（AD）的风险增加。在阿尔茨海默病中，使用N - 甲基 - [C - 11]2 -（4' - 甲基氨基苯基） - 6 - 羟基苯并噻唑（[C - 11]PIB）作为示踪剂的正电子发射断层扫描（PET）已在体内证实脑淀粉样蛋白负荷增加。
目的：研究遗忘型MCI患者是否会显示[C - 11]PIB摄取增加，这可能表明早期阿尔茨海默病进程。
方法：我们使用[C - 11]PIB作为示踪剂，对13例遗忘型MCI患者和14例对照受试者进行正电子发射断层扫描研究。通过计算60到90分钟内每个体素的区域与小脑的比率来计算参数图像。使用统计参数映射（SPM）和自动感兴趣区域（ROI）分析来分析[C - 11]PIB摄取的组间差异。
结果：SPM分析显示，MCI患者在额叶、顶叶和外侧颞叶皮质以及后扣带回中的[C - 11]PIB摄取显著高于对照受试者，后扣带回的差异最为显著。这些结果得到自动ROI分析的支持，与健康对照受试者相比，MCI患者在额叶皮质（较对照均值增加39%，p < 0.01）、后扣带回（39%，p < 0.01）、顶叶（31%，p < 0.01）和外侧颞叶（28%，p < 0.001）皮质、壳核（17%，p < 0.05）以及尾状核（25%，p < 0.05）中[C - 11]PIB摄取增加。在个体层面，在额叶皮质和后扣带回中，13例MCI患者中有8例的[C - 11]PIB摄取值高于对照均值2个标准差。至少有一个载脂蛋白E ε4等位基因的MCI受试者往往比没有载脂蛋白E ε4的MCI受试者具有更高的[C - 11]PIB摄取。
结论：在群体水平上，轻度认知障碍（MCI）患者中N - 甲基 - [C - 11]2 -（4' - 甲基氨基苯基） - 6 - 羟基苯并噻唑（[C - 11]PIB）摄取升高类似于在阿尔茨海默病（AD）中所见。在个体水平上，约一半的MCI患者的[C - 11]PIB摄取处于阿尔茨海默病范围内，提示早期阿尔茨海默病进程。
Background: Patients with mild cognitive impairment (MCI) have increased risk to develop Alzheimer disease (AD). In AD increased brain amyloid burden has been demonstrated in vivo with PET using N-methyl-[C-11]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole ([C-11]PIB) as a tracer. Objective: To investigate whether patients with amnestic MCI would show increased [C-11]PIB uptake, indicating early AD process. Methods: We studied 13 patients with amnestic MCI and 14 control subjects with PET using [C-11]PIB as tracer. Parametric images were computed by calculating the region-to-cerebellum ratio in each voxel over 60 to 90 minutes. Group differences in [C-11]PIB uptake were analyzed with statistical parametric mapping (SPM) and automated region-of-interest (ROI) analysis. Results: The SPM analysis showed that patients with MCI had significantly higher [C-11]PIB uptake vs control subjects in the frontal, parietal, and lateral temporal cortices as well as in the posterior cingulate showing the most prominent differences. These results were supported by the automated ROI analysis in which MCI patients showed in comparison with healthy control subjects increased [C-11]PIB uptake in the frontal cortex (39% increase from the control mean, p < 0.01), the posterior cingulate (39%, p < 0.01), the parietal (31%, p < 0.01) and lateral temporal (28%, p < 0.001) cortices, putamen (17%, p < 0.05), and caudate (25%, p < 0.05). Individually, in the frontal cortex and posterior cingulate, 8 of 13 patients with MCI had [C-11]PIB uptake values above 2 SD from the control mean. MCI subjects having at least one APOE epsilon 4 allele tended to have higher [C-11]PIB uptake than MCI subjects without APOE epsilon 4. Conclusions: At group level the elevated N-methyl-[C-11]2-(4'-methylaminophenyl)- 6-hydroxybenzothiazole ([C-11]PIB) uptake in patients with mild cognitive impairment (MCI) resembled that seen in Alzheimer disease (AD). At the individual level, about half of the MCI patients had [C-11]PIB uptake in the AD range, suggestive of early AD process.