Murayama Norio, Ota Kazumi, Kasanuki Koji, Kondo Daizo, Fujishiro Hiroshige, Fukase Yuko, Tagaya Hirokuni, Sato Kiyoshi, Iseki Eizo
PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan.
School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
Int J Geriatr Psychiatry. 2016 Jan;31(1):41-8. doi: 10.1002/gps.4287. Epub 2015 Mar 27.
We investigated cognitive dysfunction in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) who present hemispheric asymmetries of cerebral metabolic rate of glucose (CMRglc) decrease on (18) F-fluorodeoxyglucose positron emission tomography.
Based on the hemispheric asymmetries of CMRglc decrease in the posterior cingulate cortex, precuneus, and parietotemporal cortex, the patients were divided into three groups (a left-dominant hypometabolism group, a right-dominant hypometabolism group, and a non-dominant hypometabolism group). CMRglc decrease in the whole brain was controlled among the three groups. All the patients underwent mini-mental state examination (MMSE), Wechsler Memory Scale-Revised (WMS-R), and Wechsler Adult Intelligent Scale-Third (WAIS-III).
There were no significant differences in MMSE and WAIS-III scores among the three groups. In WMS-R, the results indicated that the left-dominant group demonstrated significantly lower scores in verbal memory than the other two groups. Furthermore, the left-dominant group had a greater tendency to be diagnosed with AD rather than aMCI.
Patients with AD and aMCI showing left-dominant hypometabolism tend to show severer impairment in verbal memory function and to be diagnosed with AD dementia.
我们研究了在(18)F-氟脱氧葡萄糖正电子发射断层扫描中出现大脑葡萄糖代谢率(CMRglc)半球不对称性降低的阿尔茨海默病(AD)和遗忘型轻度认知障碍(aMCI)患者的认知功能障碍。
根据后扣带回皮质、楔前叶和顶颞叶皮质CMRglc降低的半球不对称性,将患者分为三组(左优势低代谢组、右优势低代谢组和非优势低代谢组)。三组间全脑CMRglc降低情况得到控制。所有患者均接受简易精神状态检查(MMSE)、韦氏记忆量表修订版(WMS-R)和韦氏成人智力量表第三版(WAIS-III)。
三组间MMSE和WAIS-III评分无显著差异。在WMS-R中,结果表明左优势组在言语记忆方面的得分显著低于其他两组。此外,左优势组被诊断为AD而非aMCI的倾向更大。
表现为左优势低代谢的AD和aMCI患者往往在言语记忆功能方面表现出更严重的损害,并被诊断为AD痴呆。