Imaging Biomarkers of Neurodegeneration in Alzheimer's Disease: Distinct Contributions of Cortical MRI Atrophy and FDG-PET Hypometabolism
Imaging Biomarkers of Neurodegeneration in Alzheimer's Disease: Distinct Contributions of Cortical MRI Atrophy and FDG-PET Hypometabolism
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DOI：
10.3233/jad-180292
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发表时间：
2018-01-01
影响因子：
4
通讯作者：
Ceccaldi, Mathieu
中科院分区：
文献类型：
--
作者：
Benvenutto, Agnes;Giusiano, Bernard;Ceccaldi, Mathieu
背景：神经变性生物标志物常用于阿尔茨海默病（AD）的诊断。目的：评估两种神经影像生物标志物结构MRI和（18）FDG-PET在评估AD痴呆神经变性中各自的贡献。方法：根据临床和脑脊液标准诊断轻度AD痴呆患者。 来自马赛 ADage 队列的认知健康受试者，进行了认知、结构 MRI 和 (18)FDG-PET 评估。使用基于体素的全脑分析方法对每位患者的 MRI 萎缩程度和 (18)FDG-PET 代谢低下进行单独评估，并与健康受试者进行比较。一方面根据萎缩程度，另一方面根据代谢低下程度，然后根据结合两种生物标志物的程度的影像学特征，将患者分为不同的组。 结果：纳入了 52 名患者。 “广泛代谢低下”组的 MMSE 评分显着低于“有限代谢低下”组（分别为 19.5/30 和 23/30）。较低的 Innotest 淀粉样 Tau 指数与广泛的代谢低下相关 (p = 0.04)。 “广泛性萎缩”组中文化程度较低的患者较多，而“有限性萎缩”组中文化程度较高的患者较多（p = 0.005）。结论：（18）FDG-PET低代谢程度与AD的病理过程和临床严重程度相关，而MRI萎缩似乎受认知储备的影响。因此，在轻度 AD 痴呆的情况下，这两种神经退行性变的生物标志物不可互换，需要结合而不是单独考虑。
Background: Neurodegeneration biomarkers are routinely used in the diagnosis of Alzheimer's disease (AD).Objective: To evaluate the respective contributions of two neuroimaging biomarkers, structural MRI and (18)FDG-PET, in the assessment of neurodegeneration in AD dementia.Methods: Patients with mild AD dementia diagnosed based on clinical and cerebrospinal fluid criteria and cognitively healthy subjects, from the Marseille cohort ADAge with cognitive, structural MRI and (18)FDG-PET assessments, were included. Extent of atrophy on MRI and of hypometabolism on (18)FDG-PET were individually evaluated in each patient using a voxel-based analysis on whole-brain approach and compared to healthy subjects. Patients were divided in distinct groups according to their atrophy extent on the one hand and to their hypometabolism extent on the other, then, to their imaging profile combining the extent of the two biomarkers.Results: Fifty-two patients were included. The MMSE score was significantly lower in the "Extensive hypometabolism" group than in the "Limited hypometabolism" group (respectively 19.5/30 versus 23/30). A lower Innotest Amyloid Tau Index was associated with an extensive hypometabolism (p = 0.04). There were more patients with low educational level in the "Extensive atrophy" group, while a higher educational level was more found in the "Limited atrophy" group (p = 0.005).Conclusion: (18)FDG-PET hypometabolism extent is associated with the pathological processes and clinical severity of AD, while MRI atrophy seems to be influenced by the cognitive reserve. In the context of mild AD dementia, these two biomarkers of neurodegeneration are thus not interchangeable and require to be considered in combination rather than in isolation.