摘要
目的 脑内氟代脱氧葡萄糖(18F-FDG)PET影像可以应用于辅助痴呆的鉴别诊断。痴呆病人组和对照组同时服用葡萄糖,组间差异明显。然而,针对鉴别疾病神经元网络的一种多变量分析技术,尺度的子轮廓模型/主成分分析法(SSM/PCA)被较少应用。我们采用SSM/PCA分析法,鉴定了一种与阿尔茨海默病相关的脑葡萄糖代谢模式;此技术应用于先前确定的独立人群中。方法:为了识别与AD相关的葡萄糖代谢协方差模式,我们采用FDG-PET方法扫描了18名健康对照者和15名AD病人(鉴定的患者)。在确认的患者中(n=15),我们研究了区别可能性AD与非可能性AD的能力,(可疑性AD,轻度认知障碍(MCI)或主观评价)。结果 AD相关的代谢协方差模式的特征是颞区代谢相对下降,皮层下皮质、小脑和感觉运动皮层代谢相对增强。受试者工作特征(ROC)曲线显示真正AD类的阈值为z=1.23灵敏度和特异性分别为93%和94%。在确认的阵列中,临床上的可能AD诊断受试者显示高表达AD相关模式,然而诊断为非可能AD受试者的模式表达较低。结论 SSM/PCA鉴定的与阿尔茨海默病相关的脑葡萄糖代谢协方差模式灵敏度高,尤其是针对阿尔茨海默病。临床实践中,这种方法期望有助于阿尔茨海默病的早期诊断。
关键词: 阿尔茨海默病,临床诊断,特定疾病的脑内代谢模式,FDG-PET影像,神经心理学特征,SSM-PCA方法
Current Alzheimer Research
Title:The Alzheimer's Disease-Related Glucose Metabolic Brain Pattern
Volume: 11 Issue: 8
Author(s): Laura K. Teune, Fijanne Strijkert, Remco J. Renken, Gerbrand J. Izaks, Jeroen J. de Vries, Marcel Segbers, Jos B.T.M. Roerdink, and Klaus L. Leenders
Affiliation:
关键词: 阿尔茨海默病,临床诊断,特定疾病的脑内代谢模式,FDG-PET影像,神经心理学特征,SSM-PCA方法
摘要: Purpose: [18F]fluorodeoxyglucose (FDG) PET imaging of the brain can be used to assist in the differential diagnosis of dementia. Group differences in glucose uptake between patients with dementia and controls are well-known. However, a multivariate analysis technique called scaled subprofile model, principal component analysis (SSM/PCA) aiming at identifying diagnostic neural networks in diseases, have been applied less frequently. We validated an Alzheimer’s Disease-related (AD) glucose metabolic brain pattern using the SSM/PCA analysis and applied it prospectively in an independent confirmation cohort. Methods: We used FDG-PET scans of 18 healthy controls and 15 AD patients (identification cohort) to identify an AD-related glucose metabolic covariance pattern. In the confirmation cohort (n=15), we investigated the ability to discriminate between probable AD and non-probable AD (possible AD, mild cognitive impairment (MCI) or subjective complaints). Results: The AD-related metabolic covariance pattern was characterized by relatively decreased metabolism in the temporoparietal regions and relatively increased metabolism in the subcortical white matter, cerebellum and sensorimotor cortex. Receiver-operating characteristic (ROC) curves showed at a cut-off value of z=1.23, a sensitivity of 93% and a specificity of 94% for correct AD classification. In the confirmation cohort, subjects with clinically probable AD diagnosis showed a high expression of the AD-related pattern whereas in subjects with a non-probable AD diagnosis a low expression was found. Conclusion: The Alzheimer’s disease-related cerebral glucose metabolic covariance pattern identified by SSM/PCA analysis was highly sensitive and specific for Alzheimer’s disease. This method is expected to be helpful in the early diagnosis of Alzheimer’s disease in clinical practice.
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Laura K. Teune, Fijanne Strijkert, Remco J. Renken, Gerbrand J. Izaks, Jeroen J. de Vries, Marcel Segbers, Jos B.T.M. Roerdink, and Leenders L. Klaus, The Alzheimer's Disease-Related Glucose Metabolic Brain Pattern, Current Alzheimer Research 2014; 11 (8) . https://dx.doi.org/10.2174/156720501108140910114230
DOI https://dx.doi.org/10.2174/156720501108140910114230 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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