Is cerebral glucose metabolism related to blood-brain barrier dysfunction and intrathecal IgG synthesis in Alzheimer disease?: A 18F-FDG PET/CT study
Is cerebral glucose metabolism related to blood-brain barrier dysfunction and intrathecal IgG synthesis in Alzheimer disease?: A 18F-FDG PET/CT study
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DOI：
10.1097/md.0000000000004206
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发表时间：
2016-09-01
期刊：
影响因子：
1.6
通讯作者：
Schillaci, Orazio
中科院分区：
文献类型：
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作者：
Chiaravalloti, Agostino;Fiorentini, Alessandro;Schillaci, Orazio
本研究的目的是探讨血脑屏障 (BBB) 功能障碍、鞘内 IgG 合成和脑葡萄糖消耗之间的关系，可通过血清/脑脊液 (CSF) 白蛋白指数 (Q(alb)) 和 IgG 指数 [(CSF IgG/血清 IgG) x 血清白蛋白/CSF 白蛋白)] 和 2-脱氧-2-(F-18) 氟-d-葡萄糖检测(F-18-FDG) 正电子发射断层扫描/计算机断层扫描 (PET/CT) 在选定的受阿尔茨海默病 (AD) 影响的人群中进行。该研究纳入了 134 名根据 NINCDS-ADRDA 标准新诊断的 AD 患者。患者的平均 (+/- SD) 年龄为 70 (+/- 6) 岁；其中男性 60 人，女性 64 人。简易精神状态检查等于 18.9 (+/- 7.2)。所有患者在 F-18-FDG PET 扫描前均接受了脑脊液检测和磁共振检查。通过统计参数映射（SPM8）评估关系。我们发现对应于左颞上回的布罗德曼 42 区和 22 区的 Q(alb) 和 F-18-FDG 摄取增加之间存在显着负相关，较高的 Q(alb) 值与这些区域的葡萄糖消耗减少有关。尚未发现脑葡萄糖消耗与 IgG 指数之间存在显着关系。我们的研究结果表明，BBB 功能障碍与 AD 受试者左颞叶皮质活动减少有关。
The aim of this study was to investigate the relationships between blood-brain barrier (BBB) dysfunction, intrathecal IgG synthesis, and brain glucose consumption as detectable by means of serum/cerebrospinal fluid (CSF) albumin index (Q(alb)) and IgG index [(CSF IgG/serum IgG) x Serum albumin/CSF albumin)] and 2-deoxy-2-(F-18) fluoro-d-glucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) in a selected population affected by Alzheimer disease (AD). The study included 134 newly diagnosed AD patients according to the NINCDS-ADRDA criteria. The mean (+/- SD) age of the patients was 70 (+/- 6) years; 60 were male and 64 were female. Mini mental State Examination was equal to 18.9 (+/- 7.2). All patients underwent a CSF assay and magnetic resonance before F-18-FDG PET scanning. The relationships were evaluated by means of statistical parametric mapping (SPM8). We found a significant negative correlation between the increase of Q(alb) and F-18-FDG uptake in the Brodmann Area 42 and 22 that corresponds to the left superior temporal gyrus, with higher Q(alb) values being related to a reduced glucose consumption in these areas. No significant relationships have been found between brain glucose consumption and IgG index. The results of our study suggest that BBB dysfunction is related to reduction of cortical activity in the left temporal cortex in AD subjects.