Ishii Hiroshi, Ishikawa Hiroyasu, Meguro Kenichi, Tashiro Manabu, Yamaguchi Satoshi
Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Int Psychogeriatr. 2009 Feb;21(1):148-56. doi: 10.1017/S1041610208008132. Epub 2008 Dec 1.
Several follow-up [18F]fluorodeoxy glucose (FDG)-positron emission tomography (PET) studies have been performed in patients with mild cognitive impairment, but none have examined subjects with a Clinical Dementia Rating (CDR) of 0.5. Therefore, we used FDG-PET to investigate whether baseline glucose metabolism (CMRglc) in CDR 0.5 converters to dementia showed changes consistent with early Alzheimer's disease (AD).
Based on our earlier study, which we refer to as Prevalence Study 1998, we were able to examine 14 CDR 0, 42 CDR 0.5, and 12 AD subjects with PET and follow these subjects for five years. Baseline neuropsychological and CMRglc values were compared among groups of CDR 0, CDR 0.5/converters, CDR 0.5/non-converters, and AD subjects.
All CDR 0 subjects were reassessed as CDR 0 after the five-year period. For CDR 0.5 subjects, 20 had converted to AD and 22 remained as CDR 0.5. In cognitive tests, CDR 0.5/converters showed significantly deteriorated recent memory function compared with CDR 0.5/non-converters at the baseline evaluation. Most brain areas showed decreased CMRglc in AD patients. CDR 0.5/converters had a significantly lower baseline CMRglc in the right cingulate, left inferior parietal and left temporal gyrus compared with CDR 0.5/non-converters.
Our findings suggest that CDR 0.5/converters have a baseline metabolic decline in areas that might be specific to AD.
已对轻度认知障碍患者进行了多项随访[18F]氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）研究，但均未对临床痴呆评定量表（CDR）为0.5的受试者进行检查。因此，我们使用FDG-PET来研究CDR为0.5且后来转变为痴呆的患者的基线葡萄糖代谢（CMRglc）是否显示出与早期阿尔茨海默病（AD）一致的变化。
基于我们之前的研究（即1998年患病率研究），我们能够对14名CDR为0、42名CDR为0.5以及12名AD患者进行PET检查，并对这些受试者进行了五年的随访。比较了CDR为0、CDR为0.5且后来转变者、CDR为0.5且未转变者以及AD患者组之间的基线神经心理学和CMRglc值。
五年后，所有CDR为0的受试者重新评定为CDR为0。对于CDR为0.5的受试者，20人转变为AD，22人仍为CDR为0.5。在认知测试中，与基线评估时的CDR为0.5且未转变者相比，CDR为0.5且后来转变者的近期记忆功能显著恶化。大多数脑区在AD患者中显示CMRglc降低。与CDR为0.5且未转变者相比，CDR为0.5且后来转变者在右侧扣带回、左侧顶下小叶和左侧颞回的基线CMRglc显著降低。
我们的研究结果表明，CDR为0.5且后来转变者在可能特定于AD的区域存在基线代谢下降。
