Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease
Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease
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DOI：
10.1212/wnl.51.1.125
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发表时间：
1998-07-01
期刊：
影响因子：
9.9
通讯作者：
Mori, E
中科院分区：
文献类型：
--
作者：
Ishii, K;Imamura, T;Mori, E
目的：探讨路易体痴呆（DLB）患者脑葡萄糖区域代谢率（CMRglc）的变化特点。方法：采用f -18-氟脱氧葡萄糖（FDG）和PET对12例临床诊断为DLB的患者、12例临床诊断为阿尔茨海默病（AD）的患者和12例正常志愿者（NC）的绝对CMRglc进行比较。这三组在年龄和性别上是匹配的，DLB组和AD组在疾病持续时间和认知障碍的严重程度上没有差异。结果：DLB患者除感觉运动皮质、基底节区、丘脑和笔区外，大部分脑区CMRglc均明显低于NC。在DLB组和AD组之间，枕叶内侧和外侧的CMRglc存在显著的区域性差异。在DLB和AD中，CMRglc的减少模式相似，尽管DLB的整体代谢减少更大，并且DLB的枕部CMRglc减少可以区分DLB和AD。枕部相对CMRglc（归一化为感觉运动CMRglc）是鉴别DLB和AD的有效指标。以NC组枕部CMRglc归一化最小值为分界点，敏感性和特异性均为92%。结论：这些不同区域的CMRglc减少证实了DLB和AD之间的病理、神经化学和临床差异。
Objective: To delineate the features of regional cerebral metabolic rate of glucose (CMRglc) in dementia with Lewy bodies (DLB). Methods: We compared absolute CMRglc in 12 patients with a clinical diagnosis of DLB, 12 patients with a clinical diagnosis of Alzheimer's disease (AD), and 12 normal volunteers (NC), using F-18-fluorodeoxyglucose (FDG) and PET. The three groups were matched for age and sex, and there were no differences in disease duration or severity of cognitive disturbances between the DLB and AD groups. Results: CMRglc was significantly lower in patients with DLB than in that of NC in most parts of the brain, except the sensorimotor cortices, basal ganglia, thalamus, and pens. Between the DLB and AD groups, there were significant regional CMRglc differences in the medial and lateral occipital lobes. In DLB and AD, the CMRglc reduction patterns were similar, though the global metabolic reduction was larger in DLB, and the occipital CMRglc reduction in DLB could differentiate DLB from AD. The relative occipital CMRglc (normalized to the sensorimotor CMRglc) was a useful measure for the differential diagnosis of DLB from AD. The sensitivity and the specificity were 92% when using the minimal value of the normalized occipital CMRglc in the NC group as the cut-off point. Conclusion: These different regional CMRglc reductions substantiate the pathologic, neurochemical, and clinical differences between DLB and AD.