摘要
背景:轻度认知障碍(MCI)是介于正常认知和痴呆之间的一种状态。然而,轻度认知障碍的诊断并不一定保证其发展为痴呆。由于此前没有研究MCI-正常反转的脑正电子发射断层扫描(PET)成像,我们使用阿尔茨海默病神经成像倡议(ADNI)数据库提供了MCI-正常反转的PET成像。 方法:我们应用综合神经心理学标准(NP标准),包括记忆、语言和注意/执行功能域,包括基线诊断为MCI的患者(n=613)。根据标准将患者1年状态分为3组(回归105例,MCI稳定422例,转换86例)。对两组间的人口统计学、神经心理学、遗传学、脑脊液和认知生物标志物变量进行了比较。此外,调整混杂变量后,分别通过AV45-和FDG-PET模式比较三组间的淀粉样蛋白-β沉积模式和脑葡萄糖代谢。 结果:随访1年MCI逆转率为17.1%。逆转组APOE ε4+频率最低,脑脊液淀粉样蛋白-β水平最高,脑脊液t-tau和p-tau水平最低。神经心理评估也暗示回归组有更好的认知表现。与MCI状态稳定的患者相比,恢复正常状态的患者双侧角部和左侧颞中/下回的葡萄糖代谢较高。同时,在恢复的受试者的额叶和顶叶区域观察到较低的淀粉样蛋白β沉积。另一方面,与稳定MCI组相比,转换组双侧角脑回和双侧颞中下回的脑葡萄糖代谢较低,而淀粉样蛋白-β积累在两组间相似。 结论:这项纵向研究为PET成像在预测MCI随时间转变方面的应用提供了新的见解。
关键词: 转化,痴呆,诊断标准,轻度认知障碍,PET,逆转。
Current Alzheimer Research
Title:The Transition of Mild Cognitive Impairment Over Time: An AV45- and FDG-PET Study of Reversion and Conversion Phenomena
Volume: 18 Issue: 9
关键词: 转化,痴呆,诊断标准,轻度认知障碍,PET,逆转。
摘要:
Background: Mild cognitive impairment (MCI) is a state between normal cognition and dementia. However, MCI diagnosis does not necessarily guarantee the progression to dementia. Since no previous study investigated brain positron emission tomography (PET) imaging of MCI-- to-normal reversion, we provided PET imaging of MCI- to-normal reversion using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database.
Methods: We applied comprehensive neuropsychological criteria (NP criteria), consisting of memory, language, and attention/executive function domains, to include patients with a baseline diagnosis of MCI (n=613). According to the criteria, the year 1 status of the patients was categorized into three groups (reversion: n=105, stable MCI: n=422, conversion: n=86). Demographic, neuropsychological, genetic, CSF, and cognition biomarker variables were compared between the groups. Additionally, after adjustment for confounding variables, the deposition pattern of amyloid-β and cerebral glucose metabolism were compared between three groups via AV45- and FDG-PET modalities, respectively.
Results: MCI reversion rate was 17.1% during one year of follow-up. The reversion group had the lowest frequency of APOE ε4+ subjects, the highest CSF level of amyloid-β, and the lowest CSF levels of t-tau and p-tau. Neuropsychological assessments were also suggestive of better cognitive performance in the reversion group. Patients with reversion to normal state had higher glucose metabolism in bilateral angular and left middle/inferior temporal gyri, when compared to those with stable MCI state. Meanwhile, lower amyloid-β deposition at baseline was observed in the frontal and parietal regions of the reverted subjects. On the other hand, the conversion group showed lower cerebral glucose metabolism in bilateral angular and bilateral middle/inferior temporal gyri compared to the stable MCI group, whereas the amyloid-β accumulation was similar between the groups.
Conclusion: This longitudinal study provides novel insight regarding the application of PET imaging in predicting MCI transition over time.
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Cite this article as:
The Transition of Mild Cognitive Impairment Over Time: An AV45- and FDG-PET Study of Reversion and Conversion Phenomena, Current Alzheimer Research 2021; 18 (9) . https://dx.doi.org/10.2174/1567205018666211124110710
DOI https://dx.doi.org/10.2174/1567205018666211124110710 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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