Rowe C C, Ng S, Ackermann U, Gong S J, Pike K, Savage G, Cowie T F, Dickinson K L, Maruff P, Darby D, Smith C, Woodward M, Merory J, Tochon-Danguy H, O'Keefe G, Klunk W E, Mathis C A, Price J C, Masters C L, Villemagne V L
Department of Nuclear Medicine, Centre for PET, Austin Health, Heidelberg, Victoria, Australia.
Neurology. 2007 May 15;68(20):1718-25. doi: 10.1212/01.wnl.0000261919.22630.ea.
OBJECTIVE: To compare brain beta-amyloid (Abeta) burden measured with [(11)C]Pittsburgh Compound B (PIB) PET in normal aging, Alzheimer disease (AD), and other dementias. METHODS: Thirty-three subjects with dementia (17 AD, 10 dementia with Lewy bodies [DLB], 6 frontotemporal dementia [FTD]), 9 subjects with mild cognitive impairment (MCI), and 27 age-matched healthy control subjects (HCs) were studied. Abeta burden was quantified using PIB distribution volume ratio. RESULTS: Cortical PIB binding was markedly elevated in every AD subject regardless of disease severity, generally lower and more variable in DLB, and absent in FTD, whereas subjects with MCI presented either an "AD-like" (60%) or normal pattern. Binding was greatest in the precuneus/posterior cingulate, frontal cortex, and caudate nuclei, followed by lateral temporal and parietal cortex. Six HCs (22%) showed cortical uptake despite normal neuropsychological scores. PIB binding did not correlate with dementia severity in AD or DLB but was higher in subjects with an APOE-epsilon4 allele. In DLB, binding correlated inversely with the interval from onset of cognitive impairment to diagnosis. CONCLUSIONS: Pittsburgh Compound B PET findings match histopathologic reports of beta-amyloid (Abeta) distribution in aging and dementia. Noninvasive longitudinal studies to better understand the role of amyloid deposition in the course of neurodegeneration and to determine if Abeta deposition in nondemented subjects is preclinical AD are now feasible. Our findings also suggest that Abeta may influence the development of dementia with Lewy bodies, and therefore strategies to reduce Abeta may benefit this condition.
目的:比较正常衰老、阿尔茨海默病(AD)及其他痴呆症患者中,使用[¹¹C]匹兹堡化合物B(PIB)PET测量的脑β-淀粉样蛋白(Aβ)负荷。 方法:研究了33例痴呆患者(17例AD、10例路易体痴呆[DLB]、6例额颞叶痴呆[FTD])、9例轻度认知障碍(MCI)患者及27例年龄匹配的健康对照者(HC)。使用PIB分布容积比定量Aβ负荷。 结果:无论疾病严重程度如何,每个AD患者的皮质PIB结合均显著升高,DLB患者的皮质PIB结合通常较低且变化较大,FTD患者则无皮质PIB结合,而MCI患者呈现“AD样”模式(60%)或正常模式。结合在楔前叶/后扣带回、额叶皮质和尾状核中最强,其次是颞叶外侧和顶叶皮质。6例HC(22%)尽管神经心理学评分正常,但仍显示皮质摄取。PIB结合在AD或DLB中与痴呆严重程度无关,但在携带APOE-ε4等位基因的患者中较高。在DLB中,结合与从认知障碍发作到诊断的时间间隔呈负相关。 结论:匹兹堡化合物B PET的结果与衰老和痴呆中β-淀粉样蛋白(Aβ)分布的组织病理学报告相符。现在可行进行非侵入性纵向研究,以更好地了解淀粉样蛋白沉积在神经退行性变过程中的作用,并确定非痴呆受试者中的Aβ沉积是否为临床前期AD。我们的研究结果还表明,Aβ可能影响路易体痴呆的发展,因此降低Aβ的策略可能对这种疾病有益。
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