Department of Biofunctional Imaging, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, 431-3192, Japan.
Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka, 420-8688, Japan.
J Neurol. 2019 Sep;266(9):2186-2196. doi: 10.1007/s00415-019-09400-2. Epub 2019 May 28.
Neuronal damage and neuroinflammation are important events occurring in the brain of Alzheimer's disease (AD). The purpose of this study was to clarify in vivo mutual relationships among abnormal tau deposition, neuroinflammation and cognitive impairment in patients with early AD using positron emission tomography (PET) with [C]PBB3 and [C]DPA713.
Twenty patients with early AD and 20 age-matched normal control (NC) subjects underwent a series of PET measurements with [C]PBB3 for tau aggregation and [C]DPA713 for microglial activation (neuroinflammation). Inter- and intrasubject comparisons were performed regarding the levels of [C]PBB3 binding potential (BP) and [C]DPA713 BP in the light of cognitive functions using statistical parametric mapping (SPM) and regions of interest (ROIs) method.
The [C]PBB3 BP was greater in the temporo-parietal regions of AD patents than NC subjects, and a similar increasing pattern of [C]DPA713 BP was observed in the same patients. Correlation analyses within the AD group showed a positive direct correlation between [C]PBB3 BP and [C]DPA713 BP in the parahippocampus. Pass analysis revealed that cognitive impairment was more likely linked to the level of the parahippocampal [C]PBB3 BP than that of [C]DPA713 BP.
The pattern of abnormal tau deposition was very similar to that of neuroinflammation in patients with early-stage AD. Specifically, the direct positive correlation of tau pathology with neuroinflammation in the parahippocampus suggests that neuronal damage in this region is closely associated with microglial activation. Consistently, tau aggregation in this region matters more than neuroinflammation regarding the cognitive deterioration in AD.
神经元损伤和神经炎症是阿尔茨海默病(AD)大脑中发生的重要事件。本研究的目的是使用正电子发射断层扫描(PET)与 [C]PBB3 和 [C]DPA713 来阐明早期 AD 患者大脑中异常 tau 沉积、神经炎症和认知障碍之间的体内相互关系。
20 名早期 AD 患者和 20 名年龄匹配的正常对照(NC)受试者接受了一系列 [C]PBB3 用于 tau 聚集和 [C]DPA713 用于小胶质细胞激活(神经炎症)的 PET 测量。使用统计参数映射(SPM)和感兴趣区(ROI)方法,根据认知功能,对 [C]PBB3 结合潜能(BP)和 [C]DPA713 BP 的水平进行了受试者间和受试者内比较。
AD 患者的颞顶叶区域 [C]PBB3 BP 高于 NC 受试者,并且在同一患者中观察到类似的 [C]DPA713 BP 增加模式。AD 组内的相关性分析显示,在海马旁回中,[C]PBB3 BP 与 [C]DPA713 BP 之间存在正直接相关性。通过传递分析发现,认知障碍与海马旁回 [C]PBB3 BP 水平的相关性大于 [C]DPA713 BP 水平。
在早期 AD 患者中,异常 tau 沉积的模式与神经炎症非常相似。具体而言,tau 病理学与海马旁回神经炎症之间的直接正相关表明,该区域的神经元损伤与小胶质细胞激活密切相关。一致地,与神经炎症相比,该区域的 tau 聚集与 AD 中的认知恶化更相关。