Haxby J V, Grady C L, Koss E, Horwitz B, Heston L, Schapiro M, Friedland R P, Rapoport S I
Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Md 20892.
Arch Neurol. 1990 Jul;47(7):753-60. doi: 10.1001/archneur.1990.00530070043010.
Regional cerebral metabolic rates for glucose (rCMRglc), as measured with positron emission tomography, and neuropsychological function were studied longitudinally (range, 15 to 48 months) in 11 mildly impaired patients with dementia of the Alzheimer type (DAT) and compared with results from patients with moderate and severe DAT and from controls. At initial evaluation, association cortex metabolic asymmetries were greater in patients with DAT than in controls for all dementia severities and correlated significantly with neuropsychological discrepancies between visuospatial and language abilities in patients with moderate dementia. In mildly impaired patients, right-left metabolic asymmetries in the association cortices were directionally stable and became more pronounced over time. At initial evaluation, these patients had significant impairment, relative to controls, on tests of memory and attention to complex tasks but not on tests of language and visuospatial function. Memory, attention, language, and visuospatial impairments, however, all worsened significantly over time. In mildly impaired patients, correlations between right-left metabolic asymmetries and neuropsychological discrepancies were insignificant initially but were significant at last evaluation. These results demonstrate that heterogeneous nonmemory language and visuospatial impairments in early DAT are related to and predicted by the earlier-appearing distribution of metabolic reductions in the association neocortex.
采用正电子发射断层扫描技术测量了11例轻度认知功能受损的阿尔茨海默病型痴呆（DAT）患者的局部脑葡萄糖代谢率（rCMRglc），并对其神经心理功能进行了纵向研究（时间跨度为15至48个月），同时与中度和重度DAT患者及对照组的结果进行了比较。在初始评估时，所有痴呆严重程度的DAT患者联合皮质代谢不对称性均高于对照组，且与中度痴呆患者视觉空间和语言能力之间的神经心理差异显著相关。在轻度认知功能受损的患者中，联合皮质的左右代谢不对称性在方向上是稳定的，并且随着时间的推移变得更加明显。在初始评估时，相对于对照组，这些患者在记忆和复杂任务注意力测试中存在显著损害，但在语言和视觉空间功能测试中没有。然而，记忆、注意力、语言和视觉空间损害均随时间显著恶化。在轻度认知功能受损的患者中，左右代谢不对称性与神经心理差异之间的相关性最初不显著，但在最后评估时显著。这些结果表明，早期DAT中异质性的非记忆语言和视觉空间损害与联合新皮质中较早出现的代谢降低分布有关，并可由其预测。
