Foster Norman L, Wang Angela Y, Tasdizen Tolga, Fletcher P Thomas, Hoffman John M, Koeppe Robert A
Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA.
Alzheimers Dement. 2008 Jan;4(1 Suppl 1):S29-36. doi: 10.1016/j.jalz.2007.10.004. Epub 2007 Dec 21.
Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG-PET) thus far rarely has been used to advance the development of new treatments for Alzheimer's disease (AD). Now that FDG-PET with standard acquisition protocols for dementia is widely available, change in cerebral glucose metabolism is a feasible outcome variable for clinical drug trials. Individual analysis of FDG-PET results also might prove valuable. FDG-PET can detect metabolic changes very early in the course of AD and identify subjects for earlier treatment. FDG-PET reliably distinguishes AD from frontotemporal dementia so that only those most likely to benefit are enrolled in trials. Finally, objectively identifying phenotypic variations of AD with FDG-PET might have pathogenic and prognostic implications that can be used for personalized treatment approaches. The judicious use of FDG-PET is needed to accelerate the evaluation of promising new drugs and more rationally target treatments for dementing diseases.
正电子发射断层扫描（PET）结合18F-氟脱氧葡萄糖（FDG-PET）迄今为止很少被用于推进阿尔茨海默病（AD）新治疗方法的开发。鉴于采用标准采集方案的痴呆症FDG-PET已广泛应用，脑葡萄糖代谢变化是临床药物试验中一个可行的结果变量。对FDG-PET结果进行个体分析可能也具有重要价值。FDG-PET能够在AD病程的极早期检测到代谢变化，并识别出可进行早期治疗的受试者。FDG-PET能够可靠地将AD与额颞叶痴呆区分开来，从而使只有那些最有可能受益的患者被纳入试验。最后，利用FDG-PET客观地识别AD的表型变异可能具有致病和预后意义，可用于个性化治疗方法。需要明智地使用FDG-PET来加速对有前景的新药的评估，并更合理地针对痴呆疾病进行靶向治疗。
