Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
AJNR Am J Neuroradiol. 2010 Aug;31(7):1247-53. doi: 10.3174/ajnr.A2070. Epub 2010 Mar 18.
Decreased glucose metabolism in the temporal and parietal lobes on FDG-PET is recognized as an early imaging marker for the AD pathology. Our objective was to investigate the effects of age on FDG-PET findings in aMCI.
Twenty-five patients with aMCI at 55-86 years of age (median = 73 years) and 25 age- and sex-matched CN subjects underwent FDG-PET. SPM5 was used to compare the FDG uptake in patients in aMCI-old (>73 years) and aMCI-young (<or=73 years) groups with CN subjects. The findings in the aMCI-old patients were independently validated in a separate cohort of 10 aMCI and 13 CN subjects older than 73 years of age.
The pattern of decreased glucose metabolism and gray matter atrophy in the medial temporal, posterior cingulate, precuneus, lateral parietal, and temporal lobes in aMCI-young subjects was consistent with the typical pattern observed in AD. The pattern of glucose metabolic changes in aMCI-old subjects was different, predominantly involving the frontal lobes and the left parietal lobe. Gray matter atrophy in aMCI-old subjects was less pronounced than that in the aMCI-young subjects, involving the hippocampus and the basal forebrain in both hemispheres
Pathologic heterogeneity may be underlying the absence of AD-like glucose metabolic changes in older compared with younger patients with aMCI. This may be an important consideration for the clinical use of temporoparietal hypometabolism on FDG-PET as a marker for early diagnosis of AD in aMCI.
氟代脱氧葡萄糖正电子发射断层扫描(FDG-PET)显示颞叶和顶叶葡萄糖代谢降低,被认为是 AD 病理的早期影像学标志物。我们的目的是研究年龄对轻度认知障碍(aMCI)患者 FDG-PET 结果的影响。
25 例年龄 55-86 岁(中位数=73 岁)的 aMCI 患者和 25 名年龄和性别匹配的认知正常(CN)受试者接受了 FDG-PET 检查。使用 SPM5 比较 aMCI-老(>73 岁)和 aMCI-年轻(<=73 岁)组患者与 CN 受试者之间的 FDG 摄取。在一个独立的队列中,对 10 名 aMCI 和 13 名年龄大于 73 岁的 CN 受试者的 aMCI-老患者的结果进行了独立验证。
aMCI-年轻患者的内侧颞叶、后扣带回、楔前叶、外侧顶叶和颞叶的葡萄糖代谢降低和灰质萎缩模式与 AD 中观察到的典型模式一致。aMCI-老患者的葡萄糖代谢变化模式不同,主要涉及额叶和左侧顶叶。与 aMCI-年轻患者相比,aMCI-老患者的灰质萎缩程度较轻,累及双侧海马和基底前脑。
与年轻的 aMCI 患者相比,年龄较大的 aMCI 患者可能存在病理异质性,导致缺乏 AD 样葡萄糖代谢改变。这可能是 FDG-PET 上颞顶叶代谢低下作为 aMCI 早期 AD 诊断标志物的临床应用的一个重要考虑因素。