PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
Psychogeriatrics. 2010 Jun;10(2):62-8. doi: 10.1111/j.1479-8301.2010.00316.x.
We encountered eight early amnestic mild cognitive impairment (aMCI) patients (early MCI group) who did not fulfill the diagnostic criteria for aMCI. We compared the scores of neuropsychological examinations as well as the cerebral metabolic rate for glucose consumption (CMRglc) decrease on (18)F-FDG PET examination between the early MCI group and 10 aMCI patients (MCI group) or six normal elderly subjects (normal group), to examine whether the current diagnostic criteria can detect early-stage aMCI.
The three groups underwent Mini-Mental State Examination (MMSE), Wechsler Adult Intelligence Scale - Third Edition (WAIS-III), Wechsler Memory Scale Revised (WMS-R), magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) examinations.
The early MCI group did not show significant memory impairment of 1.0 SD or other cognitive dysfunctions on neuropsychological examinations, and did not fulfill the diagnostic criteria of aMCI. With one-way anova and Tukey's HSD post-hoc test, the early MCI group showed the highest scores for WAIS-III, whereas the MCI group showed the lowest scores for WMS-R, although there were no significant differences between the early MCI and normal groups. In order to show a discrepancy in scores between WAIS-III and WMS-R, we subtracted the scores of WMS-R from WAIS-III. Consequently, the normal group showed significantly smaller differences in scores than the other groups, although there were no significant differences between the early MCI and MCI groups. (18)F-FDG PET recognized a CMRglc decrease in the posterior cingulate gyrus and/or part of the parietotemporal area in both the MCI and early MCI groups, of which the extent and magnitude were weaker in the early MCI group. The normal group did not show a significant CMRglc.
The early MCI group should be included in aMCI not only based on the discrepancy between intelligence and memory scores, but also based on the (18)F-FDG PET findings. The combination of these examinations would make it possible to diagnose early-stage aMCI.
我们遇到了 8 例早期遗忘型轻度认知障碍（aMCI）患者（早期 MCI 组），这些患者不符合 aMCI 的诊断标准。我们比较了早期 MCI 组与 10 例 aMCI 患者（MCI 组）或 6 例正常老年人（正常组）的神经心理学检查评分和（18）F-氟代脱氧葡萄糖正电子发射断层扫描（（18）F-FDG PET）检查脑葡萄糖代谢率（CMRglc）下降情况，以探讨当前的诊断标准是否能检测到早期 aMCI。
三组患者均行简易精神状态检查（MMSE）、韦氏成人智力量表第三版（WAIS-III）、韦氏记忆量表修订版（WMS-R）、磁共振成像和 18F-氟代脱氧葡萄糖正电子发射断层扫描（（18）F-FDG PET）检查。
早期 MCI 组在神经心理学检查中无明显记忆障碍 1.0SD 或其他认知功能障碍，且不符合 aMCI 诊断标准。采用单因素方差分析和 Tukey 的 HSD 事后检验，早期 MCI 组 WAIS-III 评分最高，而 MCI 组 WMS-R 评分最低，虽然早期 MCI 组与正常组之间无显著差异。为了显示 WAIS-III 和 WMS-R 评分之间的差异，我们从 WAIS-III 中减去了 WMS-R 的评分。结果显示，正常组的评分差异明显小于其他组，尽管早期 MCI 组与 MCI 组之间无显著差异。（18）F-FDG PET 识别出 MCI 和早期 MCI 组在后扣带回和/或部分顶颞叶区域的 CMRglc 下降，其中早期 MCI 组的范围和程度较弱。正常组无明显 CMRglc。
早期 MCI 组不仅应根据智力和记忆评分的差异，还应根据（18）F-FDG PET 检查结果纳入 aMCI。这些检查的结合将有可能诊断早期 aMCI。
