IIC PiB and structural MRI provide complementary information in imaging of Alzheimers disease and amnestic mild cognitive impairment
IIC PiB and structural MRI provide complementary information in imaging of Alzheimers disease and amnestic mild cognitive impairment
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DOI：
10.1093/brain/awm336
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发表时间：
2008-03-01
期刊：
影响因子：
14.5
通讯作者：
Petersen, Ronald C.
中科院分区：
文献类型：
--
作者：
Jack, Clifford R., Jr.;Lowe, Val J.;Petersen, Ronald C.
迄今为止，淀粉样蛋白标记配体与其他成像方式之间的大多数诊断成像比较都是在使用淀粉样蛋白标记配体 C-II 匹兹堡化合物 B (PiB) 和 FDG-PET 之间进行的。我们的目标是通过基于 MRI 的海马体积和 PiB 保留测量来比较认知正常、遗忘性轻度认知障碍 (MCI) 和阿尔茨海默病受试者之间的认知表现和诊断分组区分，其次使用 3D 体素方法评估 PiB 保留和灰质损失的地形分布。对 20 名认知正常、17 名遗忘性 MCI 和 8 名可能患有阿尔茨海默病的受试者进行了 MRI 和 PiB 成像。 PiB 保留被量化为注射后 4060 分钟皮质与小脑感兴趣区域 (ROI) 的摄取比率。全球皮质 PiB 保留汇总测量源自六个皮质 ROI。统计参数映射 (SPM) 和基于体素的形态测量 (VBM) 用于在 3D 体素基础上评估 PiB 保留和灰质损失。阿尔茨海默病受试者的整体皮质 PiB 保留较高，而海马体积较低；大多数认知正常的受试者具有较低的 PiB 保留和较高的海马体积；平均而言，遗忘性 MCI 受试者的 PiB 和海马体积均处于中等水平。 1.5 的目标与小脑比率用于指定具有高或低 PiB 皮质保留的受试者。所有阿尔茨海默病受试者均低于该比率，20 名认知正常受试者中的 6 名和 17 名 MCI 受试者中的 9 名也高于此比率，表明后两组中存在双模式 PiB 保留。有趣的是，我们发现高 PiB 与低 PiB 认知正常或遗忘 MCI 受试者之间的学习和记忆表现没有一致的差异。阿尔茨海默病与认知正常受试者的 SPM/VBM 体素比较提供了补充信息，显示了淀粉样蛋白沉积和灰质损失的拓扑分布的清晰且有意义的相似性和差异。额叶具有较高的 PiB 保留，灰质损失很少，前内侧颞区具有较低的 PiB 保留，具有显着的灰质损失，而外侧颞顶联合皮层则显示出显着的 PiB 保留和灰质损失。体素 SPM 联合分析显示，无论临床类别如何，具有高 PiB 保留的受试者都具有共同的 PiB 保留拓扑模式，这与阿尔茨海默病尸检研究中淀粉样斑块的分布相匹配。整体皮质 PiB 保留和海马体积均在预期方向上与认知测试表现显着相关；然而，MRI 的相关性比 PiB 更强。成对组间诊断分离对于所有组对的 PiB 和海马体积均显着，但认知正常与遗忘 MCI 的比较除外，这对 PiB 不显着。 PiB 和 MRI 提供了补充信息，因此使用这两种方法进行临床诊断分类优于单独使用任何一种方法。
To date, most diagnostic imaging comparisons between amyloid labelling ligands and other imaging modalities have been between the use of amyloid labelling ligand C-II Pittsburgh Compound B (PiB) and FDG-PET. Our objectives were to compare cognitive performance and diagnostic group-wise discrimination between cognitively normal, amnestic mild cognitive impairment (MCI) and Alzheimers disease subjects with MRI-based measures of hippocampal volume and PiB retention, and secondly to evaluate the topographic distribution of PiB retention and grey matter loss using 3D voxel-wise methods. Twenty cognitively normal, 17 amnestic MCI and 8 probable Alzheimers disease subjects were imaged with both MRI and PiB. PiB retention was quantified as the ratio of uptake in cortical to cerebellar regions of interest (ROIs) 4060 min post-injection. A global cortical PiB retention summary measure was derived from six cortical ROIs. Statistical parametric mapping (SPM) and voxel-based morphometry (VBM) were used to evaluate PiB retention and grey matter loss on a 3D voxel-wise basis. Alzheimers disease subjects had high global cortical PiB retention and low hippocampal volume; most cognitively normal subjects had low PiB retention and high hippocampal volume; and on average amnestic MCI subjects were intermediate on both PiB and hippocampal volume. A target-to-cerebellar ratio of 1.5 was used to designate subjects with high or low PiB cortical retention. All Alzheimers disease subjects fell above this ratio, as did 6 out of 20 cognitively normal subjects and 9 out of 17 MCI subjects, indicating bi-modal PiB retention in the latter two groups. Interestingly, we found no consistent differences in learning and memory performance between high versus low PiB cognitively normal or amnestic MCI subjects. The SPM/VBM voxel-wise comparisons of Alzheimers disease versus cognitively normal subjects provided complementary information in that clear and meaningful similarities and differences in topographical distribution of amyloid deposition and grey matter loss were shown. The frontal lobes had high PiB retention with little grey matter loss, anteromedial temporal areas had low PiB retention with significant grey matter loss, whereas lateral temporoparietal association cortex displayed both significant PiB retention and grey matter loss. A voxel-wise SPM conjunction analysis revealed that subjects with high PiB retention shared a common PiB retention topographical pattern regardless of clinical category, and this matched that of amyloid plaque distribution from autopsy studies of Alzheimers disease. Both global cortical PiB retention and hippocampal volumes demonstrated significant correlation in the expected direction with cognitive testing performance; however, correlations were stronger with MRI than PiB. Pair-wise inter-group diagnostic separation was significant for all group-wise pairs for both PiB and hippocampal volume with the exception of the comparison of cognitively normal versus amnestic MCI, which was not significant for PiB. PiB and MRI provided complementary information such that clinical diagnostic classification using both methods was superior to using either in isolation.