Ballarini Tommaso, Iaccarino Leonardo, Magnani Giuseppe, Ayakta Nagehan, Miller Bruce L, Jagust William J, Gorno-Tempini Maria Luisa, Rabinovici Gil D, Perani Daniela
Università Vita-Salute San Raffaele, Milan, Italy.
In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
Hum Brain Mapp. 2016 Dec;37(12):4234-4247. doi: 10.1002/hbm.23305. Epub 2016 Jul 13.
Neuropsychiatric symptoms (NPSs) often occur in early-age-of-onset Alzheimer's disease (EOAD) and cluster into sub-syndromes (SSy). The aim of this study was to investigate the association between F-FDG-PET regional and connectivity-based brain metabolic dysfunctions and neuropsychiatric SSy. NPSs were assessed in 27 EOAD using the Neuropsychiatric Inventory and further clustered into four SSy (apathetic, hyperactivity, affective, and psychotic SSy). Eighty-five percent of EOAD showed at least one NPS. Voxel-wise correlations between SSy scores and brain glucose metabolism (assessed with F-FDG positron emission tomography) were studied. Interregional correlation analysis was used to explore metabolic connectivity in the salience (aSN) and default mode networks (DMN) in a larger sample of EOAD (N = 51) and Healthy Controls (N = 57). The apathetic, hyperactivity, and affective SSy were highly prevalent (>60%) as compared to the psychotic SSy (33%). The hyperactivity SSy scores were associated with increase of glucose metabolism in frontal and limbic structures, implicated in behavioral control. A comparable positive correlation with part of the same network was found for the affective SSy scores. On the other hand, the apathetic SSy scores were negatively correlated with metabolism in the bilateral orbitofrontal and dorsolateral frontal cortex known to be involved in motivation and decision-making processes. Consistent with these SSy regional correlations with brain metabolic dysfunction, the connectivity analysis showed increases in the aSN and decreases in the DMN. Behavioral abnormalities in EOAD are associated with specific dysfunctional changes in brain metabolic activity, in particular in the aSN that seems to play a crucial role in NPSs in EOAD. Hum Brain Mapp 37:4234-4247, 2016. © 2016 Wiley Periodicals, Inc.
神经精神症状（NPSs）常出现在早发型阿尔茨海默病（EOAD）中，并聚集成亚综合征（SSy）。本研究旨在探讨基于F-FDG-PET区域和连接性的脑代谢功能障碍与神经精神亚综合征之间的关联。使用神经精神科问卷对27例EOAD患者的NPSs进行评估，并进一步聚类为四种亚综合征（淡漠型、多动型、情感型和精神病型亚综合征）。85%的EOAD患者表现出至少一种NPS。研究了亚综合征评分与脑葡萄糖代谢（用F-FDG正电子发射断层扫描评估）之间的体素级相关性。在更大样本的EOAD患者（N = 51）和健康对照者（N = 57）中，采用区域间相关性分析来探索突显网络（aSN）和默认模式网络（DMN）中的代谢连接性。与精神病型亚综合征（33%）相比，淡漠型、多动型和情感型亚综合征的患病率较高（>60%）。多动型亚综合征评分与额叶和边缘结构中葡萄糖代谢增加有关，这些结构与行为控制有关。情感型亚综合征评分与同一网络的部分区域也存在类似的正相关。另一方面，淡漠型亚综合征评分与已知参与动机和决策过程的双侧眶额和背外侧前额叶皮质的代谢呈负相关。与这些亚综合征与脑代谢功能障碍的区域相关性一致，连接性分析显示突显网络增加而默认模式网络减少。EOAD中的行为异常与脑代谢活动的特定功能障碍变化有关，特别是在突显网络中，该网络似乎在EOAD的NPSs中起关键作用。《人类大脑图谱》37:4234 - 4247，2016年。© 2016威利期刊公司。
