Department of Neurology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Institutes of Brain Science & Collaborative Innovation Center for Brain Science, State Key Laboratory of Medical Neurobiology, Fudan University, Room 1105, Mingdao Building, 138 Yixueyuan Road, Shanghai, 200032, China.
Alzheimers Res Ther. 2018 Mar 1;10(1):26. doi: 10.1186/s13195-018-0354-2.
The underlying mechanism of brain glucose hypometabolism, an invariant neurodegenerative feature that tightly correlates with cognitive impairment and disease progression of Alzheimer's disease (AD), remains elusive.
Positron emission tomography with 2-[F]fluoro-2-deoxy-D-glucose (FDG-PET) was used to evaluate brain glucose metabolism, presented as the rate of 2-[F]fluoro-2-deoxy-D-glucose standardized uptake value ratio (FDG SUVR) in patients with AD or control subjects and in mice with or without thiamine deficiency induced by a thiamine-deprived diet. Brain amyloid-β (Aβ) deposition in patients with clinically diagnosed AD was quantified by performing assays using C-Pittsburgh compound B PET. The levels of thiamine metabolites in blood samples of patients with AD and control subjects, as well as in blood and brain samples of mice, were detected by high-performance liquid chromatography with fluorescence detection.
FDG SUVRs in frontal, temporal, and parietal cortices of patients with AD were closely correlated with the levels of blood thiamine diphosphate (TDP) and cognitive abilities, but not with brain Aβ deposition. Mice on a thiamine-deprived diet manifested a significant decline of FDG SUVRs in multiple brain regions as compared with those in control mice, with magnitudes highly correlating with both brain and blood TDP levels. There were no significant differences in the changes of FDG SUVRs in observed brain regions between amyloid precursor protein/presenilin-1 and wild-type mice following thiamine deficiency.
We demonstrate, for the first time to our knowledge, in vivo that TDP reduction strongly correlates with brain glucose hypometabolism, whereas amyloid deposition does not. Our study provides new insight into the pathogenesis and therapeutic strategy for AD.
脑葡萄糖代谢低下是阿尔茨海默病(AD)不变的神经退行性特征,与认知障碍和疾病进展密切相关,但潜在机制仍不清楚。
使用 2-[F]氟-2-脱氧-D-葡萄糖(FDG-PET)正电子发射断层扫描评估 AD 患者或对照受试者以及接受硫胺素缺乏饮食诱导的硫胺素缺乏症的小鼠的脑葡萄糖代谢,表现为 2-[F]氟-2-脱氧-D-葡萄糖标准化摄取值比(FDG SUVR)。使用 C-Pittsburgh 化合物 B PET 对临床诊断为 AD 的患者进行脑淀粉样蛋白-β(Aβ)沉积定量分析。通过高效液相色谱-荧光检测法检测 AD 患者和对照受试者的血液样本以及 AD 患者和对照受试者的血液和大脑样本中的硫胺素代谢物水平。
AD 患者额叶、颞叶和顶叶皮质的 FDG SUVR 与血液硫胺素二磷酸(TDP)水平和认知能力密切相关,但与脑 Aβ沉积无关。与对照组相比,接受硫胺素缺乏饮食的小鼠多个脑区的 FDG SUVR 明显下降,与脑和血 TDP 水平高度相关。在硫胺素缺乏后,淀粉样前体蛋白/早老素-1 和野生型小鼠观察到的脑区的 FDG SUVR 变化没有显著差异。
我们首次在体内证明,TDP 减少与脑葡萄糖代谢低下密切相关,而淀粉样蛋白沉积则没有。我们的研究为 AD 的发病机制和治疗策略提供了新的见解。