Hatashita Shizuo, Wakebe Daichi
Neurology, Shonan Atsugi Hospital, Atsugi, Japan.
Radiology, Shonan Atsugi Hospital, Atsugi, Japan.
J Alzheimers Dis. 2017;57(3):765-773. doi: 10.3233/JAD-161074.
The aim was to evaluate brain amyloid-β (Aβ) deposition in patients with mild cognitive impairment (MCI) due to Alzheimer's disease (AD) using amyloid PET imaging and clarify the relationship between the annual change in Aβ deposition and disease progression. Forty-eight MCI patients underwent neuropsychological assessment and amyloid PET imaging using [11C]-PIB over a follow-up of 5.7±1.5 years. Thirty-nine MCI patients who had an amyloid-positive scan were defined as MCI due to AD, and 9 MCI patients who had an amyloid-negative scan were included. Regions of interest were defined on co-registered MRI, and the PIB standardized uptake value ratio (SUVR) on the same regions was used over follow-up. Annual change in PIB SUVR was calculated. Patients with MCI due to AD had higher baseline PIB SUVR (1.81±0.32, n = 39, p < 0.01) and a greater annual rate of change in PIB SUVR (0.044±0.027, n = 39, p < 0.01) compared to amyloid-negative MCI patients. Twenty-eight (71.8%) progressed to AD. In patients who progressed during a short duration of 1.7±0.8 years, the annual rate of increase in PIB SUVR was 0.101±0.094 (n = 16, p < 0.05), which was greater compared to patients with long conversion or stable patients. There was a negative correlation between the annual rate of increase in PIB SUVR and duration of progression to AD among individual MCI converters (r = -0.47, n = 28, p < 0.05). The patients defined as MCI due to AD could progress to AD with a shorter period if they have a greater increased annual rate in brain Aβ deposition.
目的是使用淀粉样蛋白PET成像评估阿尔茨海默病（AD）所致轻度认知障碍（MCI）患者的脑淀粉样β蛋白（Aβ）沉积，并阐明Aβ沉积的年度变化与疾病进展之间的关系。48例MCI患者在5.7±1.5年的随访期间接受了神经心理学评估和使用[11C]-PIB的淀粉样蛋白PET成像。39例淀粉样蛋白扫描呈阳性的MCI患者被定义为AD所致MCI，9例淀粉样蛋白扫描呈阴性的MCI患者也被纳入研究。在配准的MRI上定义感兴趣区域，并在随访期间使用相同区域的PIB标准化摄取值比率（SUVR）。计算PIB SUVR的年度变化。与淀粉样蛋白阴性的MCI患者相比，AD所致MCI患者的基线PIB SUVR更高（1.81±0.32，n = 39，p < 0.01），PIB SUVR的年度变化率更大（0.044±0.027，n = 39，p < 0.01）。28例（71.8%）进展为AD。在1.7±0.8年的短时间内进展的患者中，PIB SUVR的年度增加率为0.101±0.094（n = 16，p < 0.05），与长转换期患者或病情稳定的患者相比更高。在个体MCI转换者中，PIB SUVR的年度增加率与进展为AD的持续时间之间存在负相关（r = -0.47，n = 28，p < 0.05）。被定义为AD所致MCI的患者，如果脑Aβ沉积的年度增加率更大，则可能在更短的时间内进展为AD。
