Clinical features of Pittsburgh compound-B-negative dementia
Clinical features of Pittsburgh compound-B-negative dementia
复制标题
匹兹堡复合 B 阴性痴呆的临床特征
DOI：
10.1159/000341577
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发表时间：
2012
影响因子：
2.4
通讯作者：
Takeuchi Jun
中科院分区：
文献类型：
--
作者：
Yamamoto;S.;Ouchi;Y.;Nakatsuka;D.;Tahara;T.;Mizuno;K.;Tajima;S.;Onoe;H.;Yoshikawa;E.;Tsukada;H.;Iwase;M.;Yamaguti;K.;Kuratsune;H.;Watanabe;Y;Kuratsune Daisuke;Takeuchi Jun
背景/目的：我们以前发现，一些临床诊断为阿尔茨海默病（AD）的病例通过淀粉样蛋白成像被评定为匹兹堡化合物B（PiB）阴性（即PiB阴性痴呆病例）。方法：对64例临床诊断为AD的患者中14例PiB阴性者的临床特征进行分析。结果：123 I-MIBG心肌显像显示，PiB阴性痴呆组的心脏/纵隔比值明显高于路易体痴呆（DLB）组。脑脊液生物标志物和MRI及FDG-PET结果分析提示3例嗜银颗粒病（AGD），3例额颞叶变性（FTLD），1例神经元缠结主导型痴呆（NFTD），2例AD。在VBM数据分析中，与健康对照组相比，PiB阳性AD组双侧大脑前叶明显萎缩，而PiB阴性痴呆组左侧楔前叶明显萎缩。结论：PiB阴性痴呆不太可能包括DLB，而最可能包括Tau蛋白病，如FTLD、AGD和NFTD。更好地了解PiB阴性痴呆有望进一步提高临床AD诊断的准确性。
Background/Aims:We previously found that some cases of clinically diagnosed Alzheimer’s disease (AD) were rated as Pittsburgh compound B (PiB) negative by amyloid imaging (i.e. cases of PiB-negative dementia). The present study was designed to analyze the clinical features of PiB-negative dementia patients in detail.Methods:Of the 64 cases of clinically diagnosed AD, 14 were rated PiB negative. Eleven of these were further analyzed using CSF biomarker levels and findings from MRI, FDG-PET,123I-MIBG myocardial scintigraphy and voxel-based morphometry (VBM).Results:When examined by123I-MIBG myocardial scintigraphy, the heart/mediastinum ratio was significantly higher in the PiB-negative dementia group than in the dementia with Lewy bodies (DLB) group. Analyses of CSF biomarkers and MRI and FDG-PET findings suggested argyrophilic grain disease (AGD) in 3 cases, frontotemporal lobar degeneration (FTLD) in 3 cases, neurofibrillary tangle-predominant dementia (NFTD) in 1 case, and AD in 2 cases. In the VBM data analysis, the PiB-positive AD group showed significant atrophy of both hippocampi compared with the healthy control group, while the PiB-negative dementia group presented with significant atrophy of the left precuneus.Conclusion:PiB-negative dementia is unlikely to include DLB, while it most likely includes diseases of tauopathy, such as FTLD, AGD and NFTD. A better understanding of PiB-negative dementia is expected to further improve the accuracy of the clinical AD diagnosis.