Heterogeneity of brain glucose metabolism in mild cognitive impairment and clinical progression to Alzheimer disease
Heterogeneity of brain glucose metabolism in mild cognitive impairment and clinical progression to Alzheimer disease
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DOI：
10.1001/archneur.62.11.1728
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发表时间：
2005-11-01
影响因子：
--
通讯作者：
Perani, D
中科院分区：
文献类型：
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作者：
Anchisi, D;Borroni, B;Perani, D
背景资料：遗忘型轻度认知功能障碍（amnesic mild cognitive impairment，aMCI）患者可能包括阿尔茨海默病（Alzheimer disease，AD）进展的高危患者和具有不同潜在病理状态的人群。目的：评估正电子发射断层扫描（positron emission tomography，PET）和记忆评分在识别aMCI患者和预测进展为痴呆中的潜在作用。在欧洲神经病学和AD治疗中心，67例被诊断为aMCI的患者均接受了广泛的临床和神经心理学检查以及FDG-PET研究。48例受试者定期随访至少一年，并进展为痴呆evaluated.Main结果措施：脑葡萄糖代谢和记忆scores.Results：14例aMCI谁转换为AD在1年内表现出双侧代谢低下，在下顶叶，后扣带回，内侧颞叶皮层。患有“稳定”aMCI的受试者在背外侧额叶皮质中表现为代谢减退。通过加州语言学习测试-长时间无延迟回忆评分评估的记忆障碍的严重程度与以下脑代谢模式相关：评分小于7与典型的（18）FDG-PET AD模式相关，评分7或更高与背外侧额叶皮层中的低代谢相关，并且没有进展为AD。这些数据为aMCI受试者的临床和功能异质性提供了证据，并表明（18）FDG-PET结果结合记忆评分可能有助于预测短期转化为AD。
Background: Subjects with amnesic mild cognitive impairment (aMCI) may include patients at high risk for progression to Alzheimer disease (AD) and a population with different underlying pathologic conditions.Objective: To evaluate the potential roles of positron emission tomography with fluodeoxyglucose F 18 ((18)FDG-PET) and memory scores in identifying subjects with aMCI and in predicting progression to dementia.Design, Setting, and Patients: Sixty-seven patients at European centers for neurologic and AD care who were diagnosed as having aMCI each underwent an extensive clinical and neuropsychological examination and an (18)FDG-PET study. Forty-eight subjects were followed up periodically for at least I year, and progression to dementia was evaluated.Main Outcome Measures: Brain glucose metabolism and memory scores.Results: Fourteen subjects with aMCI who converted to AD within 1 year showed bilateral hypometabolism in the inferior parietal, posterior cingulate, and medial temporal cortex. Subjects with "stable" aMCI presented with hypometabolism in the dorsolateral frontal cortex. The severity of memory impairment, as evaluated by the California Verbal Learning Test-Long Delay Free Recall scores, correlated with the following brain metabolic patterns: scores less than 7 were associated with a typical (18)FDG-PET AD pattern, and scores of 7 or higher were associated with hypornetabolism in the dorsolateral frontal cortex and no progression to AD.Conclusion: These data provide evidence for clinical and functional heterogeneity among subjects with aMCI and suggest that (18)FDG-PET findings combined with memory scores may be useful in predicting short-term conversion to AD.