Longitudinal Evaluation of Early Alzheimer's Disease Using Brain Perfusion Spect the Recruitment Was For
Longitudinal Evaluation of Early Alzheimer's Disease Using Brain Perfusion Spect the Recruitment Was For
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发表时间：
2000
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通讯作者：
Daiji Kogure;H. Matsuda;T. Ohnishi;T. Asada;M. Uno;Toshiyuki Kunihiro;S. Nakano;M. Takasaki
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作者：
Daiji Kogure;H. Matsuda;T. Ohnishi;T. Asada;M. Uno;Toshiyuki Kunihiro;S. Nakano;M. Takasaki
本单光子发射计算机断层成像（SPECT）研究的目的是利用统计参数映射（SPM）确定早期阿尔茨海默病（AD）局部脑血流（rCBF）的初始异常及纵向变化。方法：对32名主诉轻度认知障碍且初次研究时简易精神状态检查表评分大于24的患者以及45名年龄匹配的健康志愿者，使用锝 - 99m标记的双半胱乙酯SPECT无创测量rCBF。所有患者在至少2年的随访期内均符合AD的诊断标准。对患者平均间隔15个月进行随访SPECT研究。我们使用原始数据（绝对rCBF参数图）以及相对血流分布的校正rCBF图像（将每个受试者的全脑血流量[CBF]按比例缩放归一化为50 mL/100 g/min），通过SPM对这些组进行比较。结果：在基线研究中，与健康志愿者相比，患者的后扣带回和楔前叶校正rCBF显著双侧降低。在随访研究中，观察到左侧海马和海马旁回校正rCBF有选择性降低。这些区域在每次检查中绝对rCBF的降低最为显著。此外，在大脑联合皮质的广泛区域纵向观察到绝对rCBF进一步下降。结论：SPM分析显示了早期AD rCBF选择性降低和纵向下降的特征模式，这可能被传统的基于观察者先验选择和假设的感兴趣区技术所忽视。rCBF的这种改变可能与该疾病的病理生理过程密切相关。在阿尔茨海默病（AD）的研究中，近期体内神经影像学的发展使磁共振成像（MRI）、正电子发射断层成像（PET）和SPECT能够揭示内侧颞叶结构体积减小以及颞顶区局部脑血流（rCBF）减少（1 - 4）。然而，很少有纵向研究检查早期AD的影像学特征。大多数AD的影像学研究是通过感兴趣区（ROI）技术进行分析的。尽管这种方法已被普遍接受，但它受到样本选择取决于观察者先验选择和假设这一事实的限制，并且大脑的大片区域未被探索。一种替代方法是在立体定向空间中进行逐个体素分析，以避免主观性并采用数据驱动分析的原则。这种方法在功能神经影像学分析领域已经很成熟。一种被称为统计参数……的软件包
The aim of this SPECT study was to determine the initial abnormality and longitudinal changes in regional cerebral blood flow (rCBF) in early Alzheimer's disease (AD) using statistical parametric mapping (SPM). Methods: rCBF was noninvasively measured using 99mTc-ethylcysteinate dimer SPECT in 32 patients complaining of mild cognitive impairment, with a Mini-Mental State Examination score more than 24 at the initial study, and 45 age-matched healthy volunteers. All patients satisfied the diagnostic criteria of AD during the follow-up period of at least 2 y. Follow-up SPECT studies were performed on the patients at a mean interval of 15 mo. We used the raw data (absolute rCBF parametric maps) and the adjusted rCBF images of relative flow distribution (normalization of global cerebral blood flow [CBF] for each subject to 50 mL/100 g/min with proportional scaling) to compare these groups with SPM. Results: In the baseline study, the adjusted rCBF was significantly and bilaterally decreased in the posterior cingulate gyri and precunei of patients compared with healthy volunteers. In the follow-up study, selected reduction of the adjusted rCBF was observed in the left hippocampus and parahippocampal gyrus. These areas showed the most promi nent reduction in absolute rCBF on each occasion. Moreover, further decline of the absolute rCBF was longitudinally observed in extensive areas of the cerebral association cortex. Conclusion: SPM analysis showed the characteristic early-AD rCBF pattern of selective decrease and longitudinal decline, which may be overlooked by a conventional region-of-interest technique with observer a priori choice and hypothesis. This alteration in rCBF may closely relate to the pathophysiologic process of this disease. An the investigation of Alzheimer's disease (AD), recent in vivo neuroimaging developments have allowed MRI, PET, and SPECT to reveal volume decreases for medial temporal structures and reductions in regional cerebral blood flow (rCBF) in temporoparietal areas (1-4). However, few longitudinal studies have examined the imaging characteristics of early AD. Most imaging studies of AD have been analyzed by a region-of-interest (ROI) technique. Although this approach has gained general acceptance, it is limited by the fact that the selection of sample depends on the observer's a priori choice and hypothesis and leaves large areas of the brain unexplored. An alternative method is voxel-by-voxel analy sis in stereotactic space to avoid subjectivity and to adopt the principle of data-driven analysis. Such an approach is well established in the field of functional neuroimaging analysis. A software package known as statistical parametric …