Turku PET Centre, University of Turku, P.O. Box 52, 20521, Turku, Finland,
Eur J Nucl Med Mol Imaging. 2014 Feb;41(2):283-9. doi: 10.1007/s00259-013-2562-0. Epub 2013 Sep 27.
The aim of this study was to evaluate the longitudinal changes in [(11)C]PIB uptake in mild cognitive impairment (MCI) and Alzheimer's disease (AD) over a long-term follow-up.
Six AD patients, ten MCI patients and eight healthy subjects underwent a [(11)C]PIB PET scan at baseline and at 2 and 5 years. The clinical status of the MCI patients was evaluated every 6 months.
The MCI group showed a significant increase in [(11)C]PIB uptake over time (p < 0.001), with a similar increase from baseline to 2 years (4.7% per year) and from 2 to 5 years (5.0% per year). Eight MCI patients (80%) converted to AD, and two of these patients showed a normal [(11)C]PIB scan at baseline but increased uptake later. There was an increase in [(11)C]PIB uptake with time in the AD group (p = 0.02), but this did not significantly differ from the change in the control group.
Our results revealed a significant increase in amyloid load even at the time of AD diagnosis in some of the MCI patients who converted. A positive [(11)C]PIB scan at baseline in MCI patients strongly predicted future conversion to AD but a negative PIB scan in MCI patients did not exclude future conversion. The results suggest that there is wide individual variation in the brain amyloid load in MCI, and in the course of amyloid accumulation in relation to the clinical diagnosis of AD.
本研究旨在评估轻度认知障碍(MCI)和阿尔茨海默病(AD)患者在长期随访中[(11)C]PIB 摄取的纵向变化。
6 名 AD 患者、10 名 MCI 患者和 8 名健康受试者在基线和 2 年、5 年时进行 [(11)C]PIB PET 扫描。MCI 患者的临床状况每 6 个月评估一次。
MCI 组[(11)C]PIB 摄取随时间呈显著增加(p<0.001),从基线到 2 年(每年 4.7%)和从 2 年到 5 年(每年 5.0%)的增加相似。8 名 MCI 患者(80%)转化为 AD,其中 2 名患者基线时 [(11)C]PIB 扫描正常,但后来摄取增加。AD 组随时间[(11)C]PIB 摄取增加(p=0.02),但与对照组的变化无显著差异。
我们的结果显示,即使在一些转化为 AD 的 MCI 患者中,淀粉样蛋白负荷在 AD 诊断时也显著增加。MCI 患者基线时出现阳性 [(11)C]PIB 扫描强烈预测未来转化为 AD,但 MCI 患者阴性 PIB 扫描并不能排除未来转化。结果表明,MCI 患者脑内淀粉样蛋白负荷存在广泛的个体差异,与 AD 的临床诊断相关的淀粉样蛋白积累过程也存在个体差异。