Mashima Kyoko, Ito Daisuke, Kameyama Masashi, Osada Takashi, Tabuchi Hajime, Nihei Yoshihiro, Yoshizaki Takahito, Noguchi Eri, Tanikawa Mariko, Iizuka Takashi, Date Yugaku, Ogata Yuji, Nakahara Tadaki, Iwabuchi Yu, Jinzaki Masahiro, Murakami Koji, Suzuki Norihiro
Department of Neurology, Keio University School of Medicine, Tokyo, Germany.
Eur Neurol. 2017;77(5-6):231-237. doi: 10.1159/000464322. Epub 2017 Mar 11.
Most cases of dementia with Lewy bodies (DLB) show Alzheimer's disease pathology-like senile plaques and neurofibrillary tangles. Several studies have also revealed a high prevalence of positive amyloid imaging with positron emission tomography (PET) in DLB and moderate prevalence in Parkinson's disease (PD) with dementia. However, it remains unclear in PD without dementia as to when the brain β amyloid (Aβ) burden begins and progresses. Our study aimed to determine the prevalence of Aβ deposition in PD without dementia using amyloid PET.
This was a cross-sectional study on 33 patients with PD without dementia, of whom 21 had normal cognition and 12 met the criteria for PD-mild cognitive impairment. All subjects underwent neuropsychological assessment and [18F] florbetaben (FBB) PET.
All subjects had Lewy body-related disorders, displaying a significantly reduced myocardial [123I] metaiodobenzylguanidine uptake. The cortical FBB-binding pattern in all subjects, including APOE e4 carriers, suggested negative Aβ deposition.
Patients with PD without dementia exhibit an extremely low prevalence of Aβ positivity compared with those reported in cognitively normal elderly controls. Further longitudinal imaging studies and long-term follow-up are needed; however, our findings provide novel insights for understanding Aβ metabolism in PD.
大多数路易体痴呆（DLB）病例显示出类似阿尔茨海默病病理的老年斑和神经原纤维缠结。多项研究还揭示，DLB中淀粉样蛋白正电子发射断层扫描（PET）成像阳性的患病率较高，而帕金森病（PD）合并痴呆的患者中该患病率为中等。然而，在无痴呆的PD患者中，脑β淀粉样蛋白（Aβ）负担何时开始及进展尚不清楚。我们的研究旨在使用淀粉样蛋白PET确定无痴呆的PD患者中Aβ沉积的患病率。
这是一项针对33例无痴呆的PD患者的横断面研究，其中21例认知正常，12例符合PD-轻度认知障碍标准。所有受试者均接受神经心理学评估和[18F]氟比他班（FBB）PET检查。
所有受试者均患有路易体相关疾病，心肌[123I]间碘苄胍摄取显著降低。所有受试者（包括APOE e4携带者）的皮质FBB结合模式均提示Aβ沉积为阴性。
与认知正常的老年对照者相比，无痴呆的PD患者Aβ阳性的患病率极低。需要进一步的纵向影像学研究和长期随访；然而，我们的发现为理解PD中的Aβ代谢提供了新的见解。
