Mosconi Lisa, Tsui Wai H, Rusinek Henry, De Santi Susan, Li Yi, Wang Gene-Jack, Pupi Alberto, Fowler Joanna, de Leon Mony J
Center for Brain Health, MHL 400, Department of Psychiatry, New York University School of Medicine, 560 First Avenue, New York, NY 10016, USA.
Eur J Nucl Med Mol Imaging. 2007 Sep;34(9):1467-79. doi: 10.1007/s00259-007-0406-5. Epub 2007 Apr 4.
To examine CMRglc measures and corresponding glucose transport (K1 and k2) and phosphorylation (k3) rates in the medial temporal lobe (MTL, comprising the hippocampus and amygdala) and posterior cingulate cortex (PCC) in mild Alzheimer's disease (AD).
Dynamic FDG PET with arterial blood sampling was performed in seven mild AD patients (age 68+/-8 years, four females, median MMSE 23) and six normal (NL) elderly (age 69+/-9 years, three females, median MMSE 30). Absolute CMRglc (micromol/100 g/min) was calculated from MRI-defined regions of interest using multiparametric analysis with individually fitted kinetic rate constants, Gjedde-Patlak plot, and Sokoloff's autoradiographic method with population-based rate constants. Relative ROI/pons CMRglc (unitless) was also examined.
With all methods, AD patients showed significant CMRglc reductions in the hippocampus and PCC, and a trend towards reduced parietotemporal CMRglc, as compared with NL. Significant k3 reductions were found in the hippocampus, PCC and amygdala. K1 reductions were restricted to the hippocampus. Relative CMRglc had the largest effect sizes in separating AD from NL. However, the magnitude of CMRglc reductions was 1.2- to 1.9-fold greater with absolute than with relative measures.
CMRglc reductions are most prominent in the MTL and PCC in mild AD, as detected with both absolute and relative CMRglc measures. Results are discussed in terms of clinical and pharmaceutical applicability.
研究轻度阿尔茨海默病（AD）患者内侧颞叶（MTL，包括海马体和杏仁核）及后扣带回皮质（PCC）的葡萄糖代谢率（CMRglc）测量值以及相应的葡萄糖转运率（K1和k2）和磷酸化率（k3）。
对7例轻度AD患者（年龄68±8岁，4例女性，简易精神状态检查表（MMSE）中位数为23）和6例正常（NL）老年人（年龄69±9岁，3例女性，MMSE中位数为30）进行了动态氟代脱氧葡萄糖正电子发射断层扫描（FDG PET）并采集动脉血样。使用多参数分析、个体拟合动力学速率常数、Gjedde-Patlak图以及基于群体速率常数的Sokoloff放射自显影法，从MRI定义的感兴趣区域计算绝对CMRglc（微摩尔/100克/分钟）。还检查了相对感兴趣区域/脑桥CMRglc（无量纲）。
与NL组相比，所有方法均显示AD患者海马体和PCC的CMRglc显著降低，颞顶叶CMRglc有降低趋势。在海马体、PCC和杏仁核中发现k3显著降低。K1降低仅限于海马体。相对CMRglc在区分AD和NL方面的效应量最大。然而，绝对测量的CMRglc降低幅度比相对测量大1.2至1.9倍。
无论是绝对还是相对CMRglc测量，在轻度AD中MTL和PCC的CMRglc降低最为显著。从临床和药物适用性方面对结果进行了讨论。
