Pathophysiology of the behavioral variant of frontotemporal lobar degeneration: A study combining MRI and FDG-PET
Pathophysiology of the behavioral variant of frontotemporal lobar degeneration: A study combining MRI and FDG-PET
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DOI：
10.1007/s11682-016-9521-x
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发表时间：
2017-02-01
影响因子：
3.2
通讯作者：
Desgranges, B.
中科院分区：
文献类型：
--
作者：
Buhour, M-S.;Doidy, F.;Desgranges, B.
灰质（GM）叶萎缩和葡萄糖代谢低下是额颞叶变性（FTLD）的标志，但它们之间的关系仍然知之甚少。在本研究中，我们旨在显示15例FTLD行为变异体（bv-FTD）患者样本与15例健康对照相比的GM萎缩和代谢低下模式，然后使用专门设计用于统计学比较两种成像模式的基于体素的方法，直接比较GM萎缩和代谢低下。参与者接受了结构磁共振成像和F-18-氟脱氧葡萄糖（FDG）正电子发射断层扫描检查。首先，进行GM体积和代谢的组间比较。然后，在患者组中，进行区域改变和直接模态间体素比较之间的相关性。最后，我们检查了每种成像方式和每例患者的脑异常的个体模式。所观察到的GM萎缩和代谢低下的模式与先前的研究一致。我们发现GM和FDG摄取的变化之间存在显著的体素相关性，主要是在额叶皮质，对应于bv-FTD的典型改变。直接比较揭示了代谢减退和萎缩之间关系的区域差异。这项分析显示，在右侧壳核和杏仁核，以及左侧海马回和上级颞回的萎缩比代谢低下更严重，而代谢低下在左侧尾状核和前扣带回皮质比GM萎缩更严重。最后，95%的患者中，GM萎缩影响右侧杏仁核/海马和左侧杏仁核。这些结果为代谢减退和GM萎缩的层次结构的区域差异以及它们之间的关系提供了证据，并增强了我们对bv-FTD病理生理学的理解。
Gray matter (GM) lobar atrophy and glucose hypometabolism are well-described hallmarks of frontotemporal lobar degeneration (FTLD), but the relationships between them are still poorly understood. In this study, we aimed to show the patterns of GM atrophy and hypometabolism in a sample of 15 patients with the behavioral variant of FTLD (bv-FTD), compared to 15 healthy controls, then to provide a direct comparison between GM atrophy and hypometabolism, using a voxel-based method specially designed to statistically compare the two imaging modalities. The participants underwent structural magnetic resonance imaging and F-18-fluorodeoxyglucose (FDG) positron emission tomography examinations. First, between-group comparisons of GM volume and metabolism were performed. Then, in the patient group, correlations between regional alterations and direct between-modality voxelwise comparison were performed. Finally, we examined individual patterns of brain abnormalities for each imaging modality and each patient. The observed patterns of GM atrophy and hypometabolism were consistent with previous studies. We found significant voxelwise correlations between changes in GM and FDG uptake, mainly in the frontal cortex, corresponding to the typical profile of alterations in bv-FTD. The direct comparison revealed regional variability in the relationship between hypometabolism and atrophy. This analysis revealed greater atrophy than hypometabolism in the right putamen and amygdala, and left insula and superior temporal gyrus, whereas hypometabolism was more severe than GM atrophy in the left caudate nucleus and anterior cingulate cortex. Finally, GM atrophy affected the right amygdala/hippocampus and left insula in 95 % of the patients. These findings provide evidence for regional variations in the hierarchy of hypometabolism and GM atrophy and the relationships between them, and enhance our understanding of the pathophysiology of bv-FTD.