Longitudinal multimodal imaging in mild to moderate Alzheimer disease: a pilot study with memantine.
Longitudinal multimodal imaging in mild to moderate Alzheimer disease: a pilot study with memantine.
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轻度至中度阿尔茨海默氏病中的纵向多模态成像：一项对美金刚的试点研究。
DOI：
10.1136/jnnp.2007.141648
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发表时间：
2008-12
影响因子：
11
通讯作者：
Fazekas, F.
中科院分区：
文献类型：
--
作者：
Schmidt, R.;Ropele, S.;Pendl, B.;Ofner, P.;Enzinger, C.;Schmidt, H.;Berghold, A.;Windisch, M.;Kolassa, H.;Fazekas, F.
研究多模式神经影像学在轻度至中度阿尔茨海默病 (AD) 中的可行性，并估计美金刚对疾病进展的潜在功能、结构和代谢生物标志物的可能治疗效果的大小。在这项随机、双盲、安慰剂对照试点研究中，36 名中度 AD 患者接受了 52 周的美金刚（20 毫克/天）或安慰剂治疗。 26周和52周后对患者进行重新评估，以测量多项结果指标相对于基线的变化，包括整体和区域葡萄糖代谢、总脑和海马体积，以及化学位移成像衍生的整体和区域N-乙酰天冬氨酸和肌醇浓度。 52周后，总人口中整体葡萄糖代谢下降2.3%（p<0.01），总脑体积下降2.1%（p<0.001），海马体积下降2.7%（p<0.01）。化学位移成像（CSI）光谱受到患者引起的伪影的严重影响并且变化很大。与服用安慰剂的患者相比，接受美金刚的患者所有大脑区域的葡萄糖代谢下降幅度较小。他们的海马体积损失要小得多（2.4% vs 4.0%）。总脑容量的变化没有观察到组间差异。结果支持使用包括 MRI 和正电子发射断层扫描 (PET) 在内的多模态成像来监测中度 AD 的进展。 CSI 产生的纵向结果不可靠。数据表明，美金刚对 AD 具有潜在的保护作用，可用于计划更大规模的美金刚对大脑影响的验证性研究。
To study the feasibility of multimodal neuroimaging in mild to moderate Alzheimer disease (AD) and to estimate the size of possible treatment effects of memantine on potential functional, structural and metabolic biomarkers of disease progression. In this randomised, double-blind, placebo-controlled pilot study, 36 patients with moderate AD received 52 weeks of memantine (20 mg/day) or placebo. Patients were re-evaluated after 26 and 52 weeks to measure the change from baseline in several outcome measures including global and regional glucose metabolism, total brain and hippocampal volumes, as well as chemical shift imaging-derived global and regional N-acetylaspartate and myoinositol concentrations. In the total population, global glucose metabolism decreased by 2.3% (p<0.01), total brain volume by 2.1% (p<0.001) and hippocampal volume by 2.7% (p<0.01) after 52 weeks. Chemical shift imaging (CSI) spectra were severely affected by patient-induced artefacts and highly variable. Patients receiving memantine showed less decline in glucose metabolism in all brain areas than patients on placebo. Their loss of hippocampal volume was substantially smaller (2.4% vs 4.0%). No between-group differences were seen for changes in total brain volume. The results support the use of multimodal imaging including MRI and positron emission tomography (PET) to monitor the progression of moderate AD. CSI yielded unreliable longitudinal results. The data suggest that memantine has potentially protective effects in AD and they can be used for planning larger confirmatory studies on the cerebral effects of memantine.
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168.9
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