Neurobehavioral Characteristics of FDG-PET Defined Right-Dominant Semantic Dementia: A Longitudinal Study.
Neurobehavioral Characteristics of FDG-PET Defined Right-Dominant Semantic Dementia: A Longitudinal Study.
复制标题
DOI：
10.1159/000513979
复制
发表时间：
2021
影响因子：
2.4
通讯作者：
Josephs KA
中科院分区：
文献类型：
--
作者：
Curet Burleson AX;Pham NTT;Buciuc M;Botha H;Duffy JR;Clark HM;Utianski RL;Machulda MM;Baker MC;Rademakers R;Lowe VJ;Whitwell JL;Josephs KA
语义性痴呆(SD)的特点是言语流利、失范、词语和客体知识丧失，在[18F]氟脱氧葡萄糖(FDG)PET上表现为不同程度的右、左前内侧颞叶低代谢。我们通过三种FDG-PET定义的代谢模式评估了语义性痴呆患者的神经行为特征，并调查了随时间的进展。34例完成FDG-PET的SD患者根据各颞叶代谢低下的程度被分为左右优势组。根据右侧颞叶代谢低下与对照组(左侧+组)的标准差是否大于或小于2个标准差，进一步细分左侧优势组。用神经精神病学问卷(NPI-Q)测定的神经行为特征在不同组间进行比较。对14名受试者进行纵向随访，评估NPI-Q评分和FDG-PET低代谢的进展情况。与左侧优势组相比，右侧优势组在NPI-Q上的表现更差，异常行为的频率更高，去抑制更严重。在NPI-Q上的表现和去抑制的严重程度与右侧内侧和外侧的颞叶低代谢有关，但与左侧无关。大多数左侧显性受试者和左侧+受试者的异常行为的严重程度随着时间的推移而恶化，但在纵向随访的两个右侧显性受试者中，异常行为的严重性似乎有所改善。随着时间的推移，所有的组都显示出双侧颞叶代谢的进行性恶化，低代谢从前内侧扩散到后颞区。然而，随着时间的推移，颞叶不对称的程度保持相对恒定。在语义性痴呆中，神经行为特征，特别是去抑制，与右侧内侧和外侧颞叶低代谢有关，通常会随着时间的推移而发展，即使在呈现左侧主导低代谢模式的受试者中也是如此。
Semantic dementia (SD) is characterized by fluent speech, anomia and loss of word and object knowledge with varying degrees of right and left anterior-medial temporal lobe hypometabolism on [18F] fluorodeoxyglucose (FDG) PET. We assess neurobehavioral features in semantic dementia patients across three FDG-PET defined metabolic patterns, and investigated progression over time. Thirty-four subjects with SD who completed FDG-PET were classified into a left and right dominant group based on the degree of hypometabolism in each temporal lobe. The left dominant group was further sub-divided depending on whether hypometabolism in the right temporal lobe was more or less than 2 standard deviations from controls (left+ group). Neurobehavioral characteristics determined using the Neuropsychiatric Inventory-Questionnaire (NPI-Q) were compared across groups. Progression of NPI-Q scores and FDG-PET hypometabolism was assessed in 14 subjects with longitudinal follow-up. The right-dominant group performed worse on the NPI-Q, had a greater frequency of abnormal behaviors and more severe disinhibition compared to the left-dominant group. Performance on the NPI-Q and severity of disinhibition correlated with right medial and lateral, but not left, temporal lobe hypometabolism. Severity of abnormal behaviors worsened over time in most left-dominant and left+ subjects, but appeared to improve in the two right-dominant subjects with longitudinal follow-up. All groups showed progressive worsening of metabolism in both temporal lobes over time, with hypometabolism spreading from anteromedial to posterior temporal regions. However, degree of temporal lobe asymmetry remained relatively constant over time. In semantic dementia, neurobehavioral features, especially disinhibition, are associated with right medial and lateral temporal lobe hypometabolism and commonly develop over time even in subjects that present with left-dominant patterns of hypometabolism.