Clinically Different Stages of Alzheimer's Disease Associated by Amyloid Deposition with [11C]-PIB PET Imaging
Clinically Different Stages of Alzheimer's Disease Associated by Amyloid Deposition with [11C]-PIB PET Imaging
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DOI：
10.3233/jad-2010-100222
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发表时间：
2010-01-01
影响因子：
4
通讯作者：
Yamasaki, Hidetomo
中科院分区：
文献类型：
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作者：
Hatashita, Shizuo;Yamasaki, Hidetomo
我们研究了[C-11]-PIB PET是否在阿尔茨海默病（AD）和临床前痴呆的临床不同阶段检测潜在的淀粉样蛋白沉积。日本队列的214例受试者接受了认知测试和60分钟动态[C-11]-PIB PET。在注射后35-60 min采集[C-11]-PIB数据。在共同配准的MRI上定义感兴趣区域。使用Logan图形分析确定PIB保留的分布体积比（DVR）。所有56例AD患者均显示皮质区PIB滞留显著增加（典型PIB AD模式）。11名中度AD患者的平均DVR值（CDR：2.1 +/- 0.4）显示出比淀粉样蛋白阴性健康对照（HC）受试者显著更高的PIB保留（2.38 +/- 0.42，p < 0.01）。23名极轻度AD患者（CDR：0.5）和22名轻度AD患者（CDR：1.0）的DVR值分别为2.32 +/- 0.45和2.34 +/- 0.42，与中度AD相似。相比之下，58例轻度认知功能障碍（MCI）患者中有28例（48%）（MMSE：27.3 +/- 1.7）显示出典型的AD样模式，DVR值为2.07 +/- 0.34。此外，91例HC受试者中有17例（18%）具有典型的AD样模式，DVR值为2.06 +/- 0.28。它们与非常轻度的AD没有显著差异。在53例75岁以上的淀粉样蛋白阳性患者中，AD的患病率大幅增加至74%，而淀粉样蛋白阳性的HC仅下降9%，淀粉样蛋白阳性的MCI下降17%。前驱AD和AD痴呆是基于认知功能和淀粉样蛋白沉积通过PIB PET成像鉴定的。此外，皮质淀粉样蛋白沉积可以在AD的临床前阶段检测到。
We investigated whether [C-11]-PIB PET detects underlying amyloid deposition at clinically different stages of Alzheimer's disease (AD) and preclinical dementia. The Japanese cohort of 214 subjects underwent cognitive testing and 60-min dynamic [C-11]-PIB PET. [C-11]-PIB data were acquired from 35-60 min after injection. Regions of interest were defined on co-registered MRI. Distribution volume ratios (DVR) of PIB retention were determined using Logan graphical analysis. All 56 patients with AD showed a robust increase in PIB retention in cortical areas (typical PIB AD-pattern). A mean DVR value in 11 patients with moderate AD (CDR: 2.1 +/- 0.4) showed significantly higher PIB retention (2.38 +/- 0.42, p < 0.01) than amyloid-negative healthy control (HC) subjects. The DVR values in 23 patients with very mild AD (CDR: 0.5) and 22 patients with mild AD (CDR: 1.0) were 2.32 +/- 0.45 and 2.34 +/- 0.42, respectively, similar to moderate AD. In contrast, 28 (48%) of the 58 mild cognitive impairment (MCI) patients (MMSE: 27.3 +/- 1.7) showed a typical AD-like pattern with a DVR value of 2.07 +/- 0.34. Further, 17 (18%) of 91 HC subjects had a typical AD-like pattern with a DVR value of 2.06 +/- 0.28. They did not significantly differ from very mild AD. The prevalence of AD among the 53 amyloid positive patients aged 75 years or older increased greatly to 74% whereas that of amyloid positive HC decreased by only 9% and amyloid positive MCI by 17%. Prodromal AD and AD dementia is identified, based on cognitive function and amyloid deposition by PIB PET imaging. Further, the cortical amyloid deposition could be detected at preclinical stage of AD.