Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan.
Geriatr Gerontol Int. 2019 Mar;19(3):197-202. doi: 10.1111/ggi.13586. Epub 2018 Dec 12.
The aim of the present study was to examine the differences in the brain perfusion single-photon emission computed tomography patterns compared in dementia with Lewy bodies (DLB) with or without cingulate island sign (CIS).
A total of 43 patients with DLB and 63 patients with Alzheimer's disease (AD) were included in the study. The CIScore was determined based on the posterior cingulate area and the occipital cortex using the eZIS software. The CIScore was analyzed using receiver operating characteristic curve analysis. Statistical parametric mapping 8 was used for the voxel-by-voxel group analysis of single-photon emission computed tomography.
The mean CIScore was significantly lower in DLB patients than in Alzheimer's disease patients. The age at examination was higher in the normal CIScore subgroup than in the abnormal CIScore subgroup based on optimal cut-off value. Statistical parametric mapping 8 analysis showed Alzheimer's disease-specific hypoperfusion in the normal-CIScore subgroup. Furthermore, stratifying the patients by age before applying the optimal CIScore cut-off improved the largest area under the receiver operating characteristic curve in patients aged ≤78 years compared with patients aged >79 years.
The present findings suggest that older DLB patients might have a normal CIScore because of concomitant multiple pathology. Therefore, age should be considered when interpreting the CIScore. Geriatr Gerontol Int 2019; 19: 197-202.
本研究旨在比较伴或不伴扣带回岛征(CIS)的路易体痴呆(DLB)患者的脑灌注单光子发射计算机断层扫描(SPECT)模式差异。
共纳入 43 例 DLB 患者和 63 例阿尔茨海默病(AD)患者。采用 eZIS 软件,根据后扣带回区和枕叶皮质确定 CIScore。采用受试者工作特征曲线分析对 CIScore 进行分析。采用统计参数图 8 对 SPECT 的体素进行组间分析。
DLB 患者的平均 CIScore 显著低于 AD 患者。根据最佳截断值,CIScore 正常亚组的检查年龄高于 CIScore 异常亚组。统计参数图 8 分析显示,CIScore 正常亚组存在 AD 特异性低灌注。此外,在应用最佳 CIScore 截断值之前,按年龄分层患者可以改善≤78 岁患者的受试者工作特征曲线下面积,而>79 岁患者的面积则降低。
本研究结果提示,由于合并多种病变,年龄较大的 DLB 患者可能具有正常的 CIScore。因此,在解释 CIScore 时应考虑年龄因素。老年医学与老年病学杂志 2019;19:197-202.