University of Melbourne, Carlton South, Australia.
Stroke. 2012 May;43(5):1341-6. doi: 10.1161/STROKEAHA.111.636266. Epub 2012 Apr 5.
Conflicting evidence exists as to whether focal cerebral ischemia contributes to cerebral amyloid deposition. We aimed to look at Aβ deposits, detected by N-methyl-2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (PiB) positron emission tomography, in patients with recent ischemic stroke. Specifically, we hypothesized that patients with recent ischemic stroke have higher local and neocortical PiB positron emission tomography retention and that this may be associated with major vascular risk factors.
Ischemic stroke patients were studied using PiB positron emission tomography within 30 days and compared to age-matched controls. Distribution volume ratio maps were created using Logan graphical analysis with the cerebellar cortex as a reference.
Among the 21 ischemic stroke patients (median age, 76 years; interquartile range, 68-77), the ipsilateral peri-infarct region PiB retention was higher compared to the contralateral mirror region, with a PiB distribution volume ratio difference of 0.29 (95% CI, 0.2-0.44; P=0.001) at median 10 (interquartile range, 7-14) days after stroke. Two patients also had higher PiB retention within the infarct compared to the contralateral side. There was no difference in the neocortical PiB retention elsewhere in the brain among ischemic stroke patients compared with 22 age-matched normal controls (P=0.22). Among the risk factors in the ischemic stroke patients, diabetes was associated with a higher neocortical PiB retention (Spearman Rho=0.48; 95% CI, 0.28-0.72).
PiB retention was higher in the peri-infarct region among patients with recent ischemic stroke. This did not translate into a higher global neocortical PiB retention except possibly in patients with diabetes. The cause of the focal PiB retention is uncertain and requires further investigation.
关于局灶性脑缺血是否会导致脑淀粉样蛋白沉积，目前仍存在相互矛盾的证据。我们旨在观察近期发生缺血性脑卒中患者的 Aβ 沉积情况，这些 Aβ 沉积通过 N-甲基-2-(4'-甲基氨基苯基)-6-羟基苯并噻唑（PiB）正电子发射断层扫描术检测。具体而言，我们假设近期发生缺血性脑卒中的患者存在更高的局部和新皮质 PiB 正电子发射断层扫描术保留，且这可能与主要血管危险因素相关。
对 21 例在 30 天内发生缺血性脑卒中的患者进行 PiB 正电子发射断层扫描术检查，并与年龄匹配的对照组进行比较。使用 Logan 图形分析法生成分布容积比图，以小脑皮质作为参照。
在 21 例缺血性脑卒中患者（中位年龄 76 岁；四分位间距为 68-77 岁）中，与对侧镜像区域相比，同侧梗死周边区域的 PiB 保留较高，中位数为 10（四分位间距为 7-14）天时 PiB 分布容积比差异为 0.29（95%置信区间为 0.2-0.44；P=0.001）。有 2 例患者的梗死区内的 PiB 保留也高于对侧。与 22 例年龄匹配的正常对照者相比，缺血性脑卒中患者在大脑其他部位的新皮质 PiB 保留无差异（P=0.22）。在缺血性脑卒中患者的危险因素中，糖尿病与新皮质 PiB 保留增加相关（Spearman Rho=0.48；95%置信区间为 0.28-0.72）。
近期发生缺血性脑卒中患者的梗死周边区域的 PiB 保留较高。除了可能患有糖尿病的患者外，这种情况并未导致全局新皮质 PiB 保留的增加。局灶性 PiB 保留的原因尚不清楚，需要进一步研究。
