Knopman David S, Jack Clifford R, Lundt Emily S, Weigand Stephen D, Vemuri Prashanthi, Lowe Val J, Kantarci Kejal, Gunter Jeffrey L, Senjem Matthew L, Mielke Michelle M, Machulda Mary M, Roberts Rosebud O, Boeve Bradley F, Jones David T, Petersen Ronald C
Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA.
Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA.
Neurobiol Aging. 2016 Oct;46:32-42. doi: 10.1016/j.neurobiolaging.2016.06.003. Epub 2016 Jun 16.
The availability of antemortem biomarkers for Alzheimer's disease (AD) enables monitoring the evolution of neurodegenerative processes in real time. Pittsburgh compound B (PIB) positron emission tomography (PET) was used to select participants in the Mayo Clinic Study of Aging and the Mayo Alzheimer's Disease Research Center with elevated β-amyloid, designated as "A+," and hippocampal volume and (18)fluorodeoxyglucose (FDG) positron emission tomography were used to characterize participants as having evidence of neurodegeneration ("N+") at the baseline evaluation. There were 145 clinically normal (CN) A+ individuals, 62 persons with mild cognitive impairment (MCI) who were A+ and 20 with A+ AD dementia. Over a period of 1-6 years, MCI A+N+ individuals showed declines in medial temporal, lateral temporal, lateral parietal, and to a lesser extent, medial parietal regions for both FDG standardized uptake value ratio and gray matter volume that exceeded declines seen in the CN A+N+ group. The AD dementia group showed declines in the same regions on FDG standardized uptake value ratio and gray matter volume with rates that exceeded that in MCI A+N+. Expansion of regional involvement and faster rate of neurodegeneration characterizes progression in the AD pathway.
阿尔茨海默病（AD）生前生物标志物的可用性使得实时监测神经退行性变过程的进展成为可能。匹兹堡化合物B（PIB）正电子发射断层扫描（PET）被用于在梅奥诊所衰老研究和梅奥阿尔茨海默病研究中心中挑选β-淀粉样蛋白水平升高的参与者，这些参与者被指定为“A+”，同时利用海马体积和（18）氟脱氧葡萄糖（FDG）正电子发射断层扫描在基线评估时将参与者表征为有神经退行性变证据（“N+”）。有145名临床正常（CN）的A+个体、62名轻度认知障碍（MCI）的A+个体以及20名A+的AD痴呆患者。在1至6年的时间里，MCI A+N+个体在FDG标准化摄取值比率和灰质体积方面，在内侧颞叶、外侧颞叶、外侧顶叶以及程度较轻的内侧顶叶区域出现的下降超过了CN A+N+组。AD痴呆组在相同区域的FDG标准化摄取值比率和灰质体积下降速率超过了MCI A+N+组。区域受累范围的扩大和更快的神经退行性变速率是AD病程进展的特征。
