Amyloid-β assessed by florbetapir F 18 PET and 18-month cognitive decline A multicenter study
Amyloid-β assessed by florbetapir F 18 PET and 18-month cognitive decline A multicenter study
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DOI：
10.1212/wnl.0b013e3182661f74
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发表时间：
2012-10-01
期刊：
影响因子：
9.9
通讯作者：
Pontecorvo, Michael J.
中科院分区：
文献类型：
--
作者：
Doraiswamy, P. Murali;Sperling, Reisa A.;Pontecorvo, Michael J.
目的：Forbetapir F18PET可以成像活体受试者大脑中的淀粉样β蛋白(Aβ)聚集体。我们前瞻性地评估了在进行性认知功能衰退的风险人群中使用florbetapir PET检测Aβ病理的预后价值。方法：共有151名先前参与多中心florbetapir PET成像研究的受试者被招募进行纵向评估。受试者包括51名新近诊断的轻度认知障碍(MCI)、69名认知正常的对照组(CN)和31名临床诊断为阿尔茨海默病痴呆(AD)的患者。对于β-淀粉样蛋白聚集的病理水平，PET图像在视觉上被评分为阳性(Aβ+)或阴性(Aβ-)，而不进行诊断分类。根据基线PET图像确定大脑与小脑的标准化摄取值比率(SUVR)。受试者被跟踪18个月，以评估认知和诊断状态的变化。结果：在MCI和CN中，基线Aβ+扫描与阿尔茨海默病评估量表-认知子量表(ADAS-Cog(p<；0.01)和临床痴呆评定量表(CDR-SB)(p<；0.02)的临床恶化程度相关(p<；0.01)。在MCI Aβ+扫描中，记忆力、数字符号替换(DSS)和简易智力状态检查(MMSE)也与更大程度的下降相关(p<；0.05)。在MCI中，更高的基线SUVR同样与ADAS-Cog(p<；0.01)、CDR-SB(p<；0.03)、记忆测量、DSS和MMSE(p<；0.05)的随后更大的下降相关。Aβ+MCI转化为AD痴呆的比率高于Aβ受试者(p<；0.10)。结论：florbetapir PET有助于识别进行性认知衰退风险增加的个体。神经病学(R)2012；79：1636-1644
Objectives: Florbetapir F 18 PET can image amyloid-beta (A beta) aggregates in the brains of living subjects. We prospectively evaluated the prognostic utility of detecting A beta pathology using florbetapir PET in subjects at risk for progressive cognitive decline.Methods: A total of 151 subjects who previously participated in a multicenter florbetapir PET imaging study were recruited for longitudinal assessment. Subjects included 51 with recently diagnosed mild cognitive impairment (MCI), 69 cognitively normal controls (CN), and 31 with clinically diagnosed Alzheimer disease dementia (AD). PET images were visually scored as positive (A beta+)or negative (A beta-) for pathologic levels of beta-amyloid aggregation, blind to diagnostic classification. Cerebral to cerebellar standardized uptake value ratios (SUVr) were determined from the baseline PET images. Subjects were followed for 18 months to evaluate changes in cognition and diagnostic status. Analysis of covariance and correlation analyses were conducted to evaluate the association between baseline PET amyloid status and subsequent cognitive decline.Results: In both MCI and CN, baseline A beta+ scans were associated with greater clinical worsening on the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog (p < 0.01) and Clinical Dementia Rating-sum of boxes (CDR-SB) (p < 0.02). In MCI A beta+ scans were also associated with greater decline in memory, Digit Symbol Substitution (DSS), and Mini-Mental State Examination (MMSE) (p < 0.05). In MCI, higher baseline SUVr similarly correlated with greater subsequent decline on the ADAS-Cog (p < 0.01), CDR-SB (p < 0.03), a memory measure, DSS, and MMSE (p < 0.05). A beta+ MCI tended to convert to AD dementia at a higher rate than A beta- subjects (p < 0.10).Conclusions: Florbetapir PET may help identify individuals at increased risk for progressive cognitive decline. Neurology (R) 2012; 79: 1636-1644