Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany; Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Neurobiol Aging. 2018 May;65:41-50. doi: 10.1016/j.neurobiolaging.2018.01.002. Epub 2018 Jan 31.
Structural deterioration and volume loss of the hippocampal formation is observed in many diseases associated with memory decline. Paradoxically, glucose metabolism of the hippocampal formation can be increased at the same time. This might be a consequence of compensatory (beneficial) or maladaptive (detrimental) mechanisms. Aim of this study was to differentiate between compensation and maladaptation by analyzing the association between glucose metabolism in the hippocampal formation measured by positron emission tomography with the glucose analogue 18F-fluorodeoxyglucose and cognitive performance as characterized by the extended Consortium to Establish a Registry for Alzheimer's Disease test battery in a sample of 87 patients (81.8 ± 5.4 years) with mild cognitive impairment or mild dementia and varying etiological diagnoses. Glucose metabolism in the hippocampal formation was negatively correlated with the performance in several cognitive subdomains, most pronounced for verbal semantic fluency, independent of overall neuronal dysfunction, presence of clinical Alzheimer's disease, and overall cognitive performance. This finding provides evidence that increased glucose metabolism in the hippocampal formation of cognitively impaired patients indicates detrimental maladaptation rather than a beneficial compensatory reaction. Excess glucose metabolism in the hippocampal formation might be a useful therapeutic target in these patients.
在许多与记忆衰退相关的疾病中，都观察到海马结构的结构恶化和体积损失。矛盾的是，海马结构的葡萄糖代谢同时可能增加。这可能是补偿（有益）或适应不良（有害）机制的结果。本研究的目的是通过分析正电子发射断层扫描测量的海马葡萄糖代谢与认知表现之间的关系，来区分补偿和适应不良，认知表现由扩展的阿尔茨海默病登记研究联盟测试组合来描述，该组合包括 87 名患有轻度认知障碍或轻度痴呆症且病因诊断不同的患者（81.8±5.4 岁）。海马葡萄糖代谢与多个认知子领域的表现呈负相关，与语言语义流畅性的相关性最显著，与整体神经元功能障碍、临床阿尔茨海默病的存在和整体认知表现无关。这一发现为葡萄糖代谢增加表明认知障碍患者的有害适应不良而不是有益的补偿反应提供了证据。海马葡萄糖代谢过多可能是这些患者的一个有用的治疗靶点。
