Udo Niki, Hashimoto Naoki, Toyonaga Takuya, Isoyama Tomoyuki, Oyanagi Yuka, Narita Hisashi, Shiga Tohru, Nakagawa Shin, Kusumi Ichiro
Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Dement Geriatr Cogn Dis Extra. 2020 Sep 9;10(2):86-93. doi: 10.1159/000509278. eCollection 2020 May-Aug.
Apathy is a common neuropsychiatric symptom in patients with Alzheimer's disease (AD). The striatal binding potential (BP) of I-FP-CIT (-δ-fluoropropyl-2β-carbomethoxy-3β-[4-iodophenyl]tropane) single-photon emission computed tomography (SPECT) is correlated with the degree of apathy in patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB). This study aimed to determine if dopaminergic activity in the basal ganglia is associated with the development of apathy in AD.
Nineteen subjects with AD were included and underwent I-FP-CIT-SPECT. Patients with other types of dementia as a comorbidity, those taking antidepressants, and those with overt parkinsonism were excluded. Apathy was assessed using the Apathy Evaluation Scale Informant-Japanese version (AES-I-J). SPECT images were overlaid with images in striatal regions of interest (ROIs), and the SPECT values in these regions were counted. The relationship between BP values and AES-I-J scores was investigated using Spearman's rank correlation coefficient.
Significant inverse correlations were observed between BP values and AES-I-J scores in the left caudate nucleus and there was a marginally significant inverse correlation in the right caudate nucleus.
The pathological basis of apathy might be the impairment of the dopaminergic nervous system. Further studies on more subjects with AD, healthy controls, and patients with PD and DLB are needed.
淡漠是阿尔茨海默病（AD）患者常见的神经精神症状。1-氟丙基-2β-甲氧基-3β-[4-碘苯基]托烷（I-FP-CIT）单光子发射计算机断层扫描（SPECT）的纹状体结合潜能（BP）与帕金森病（PD）和路易体痴呆（DLB）患者的淡漠程度相关。本研究旨在确定基底节区的多巴胺能活性是否与AD患者淡漠的发生有关。
纳入19例AD患者并进行I-FP-CIT-SPECT检查。排除合并其他类型痴呆的患者、服用抗抑郁药的患者以及有明显帕金森综合征的患者。使用淡漠评估量表 informant-日语版（AES-I-J）评估淡漠情况。将SPECT图像与纹状体感兴趣区（ROI）的图像叠加，并计算这些区域的SPECT值。使用Spearman等级相关系数研究BP值与AES-I-J评分之间的关系。
在左侧尾状核中观察到BP值与AES-I-J评分之间存在显著负相关，在右侧尾状核中存在边缘显著的负相关。
淡漠的病理基础可能是多巴胺能神经系统的损害。需要对更多的AD患者、健康对照以及PD和DLB患者进行进一步研究。
