Arnáiz E, Jelic V, Almkvist O, Wahlund L O, Winblad B, Valind S, Nordberg A
Karolinska Institutet, Department of Clinical Neuroscience, Occupational Therapy, and Elderly Care Research (NEUROTEC), Huddinge University Hospital, Sweden.
Neuroreport. 2001 Mar 26;12(4):851-5. doi: 10.1097/00001756-200103260-00045.
The objective of this study was to assess whether reduced glucose metabolism (rCMRGlu) and cognitive functioning could predict development of Alzheimer's disease (AD) in subjects with mild cognitive impairment (MCI). Twenty MCI patients underwent baseline and follow-up investigations of rCMRGlu, as measured by PET, and cognitive function measured by neuropsychological test assessments. Subjects were clinically followed up with an average interval of 36.5 months. Two groups were obtained after the second clinical assessment. Nine patients were diagnosed as AD and classified as progressive MCI (P-MCI), whereas 11 patients remained clinically stable and were classified as stable MCI (S-MCI). There were no differences in demographic variables or baseline MMSE between the two subgroups. Logistic regression indicated the two variables that most effectively predicted future development of AD were rCMRGlu from the left temporoparietal area and performance on the block design. These combined measures gave an optimal 90% correct classification rate, whereas only rCMRGlu or neuropsychology alone gave 75% and 65% correct classification, respectively. Measures of temporoparietal cerebral metabolism and visuospatial function may aid in predicting the evolution to AD for patients with MCI.
本研究的目的是评估葡萄糖代谢降低（rCMRGlu）和认知功能是否能够预测轻度认知障碍（MCI）患者患阿尔茨海默病（AD）的情况。20名MCI患者接受了rCMRGlu的基线和随访检查（通过PET测量）以及认知功能检查（通过神经心理学测试评估）。对受试者进行临床随访，平均间隔时间为36.5个月。第二次临床评估后分为两组。9名患者被诊断为AD，并归类为进展性MCI（P-MCI），而11名患者临床症状保持稳定，被归类为稳定MCI（S-MCI）。两个亚组在人口统计学变量或基线简易精神状态检查表（MMSE）方面没有差异。逻辑回归表明，最能有效预测AD未来发展的两个变量是左颞顶叶区域的rCMRGlu和积木设计测试的表现。这些综合指标的正确分类率最佳，为90%，而仅rCMRGlu或仅神经心理学测试的正确分类率分别为75%和65%。颞顶叶脑代谢和视觉空间功能的测量可能有助于预测MCI患者向AD的演变。
