Dept. of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany.
Dept. of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany.
Neuroimage Clin. 2021;29:102535. doi: 10.1016/j.nicl.2020.102535. Epub 2020 Dec 16.
Reserve is defined as the ability to maintain cognitive functions relatively well at a given level of pathology. Early life experiences such as education are associated with lower dementia risk in general. However, whether more years of education guards against the impact of brain alterations also in frontotemporal dementia (FTD) has not been shown in a large patient collective. Therefore, we assessed whether education is associated with relatively high cognitive performance despite the presence of [F]-fluorodeoxyglucose positron-emission-tomography (FDG-PET) hypometabolism in FTD.
Sixty-six FTD subjects (age 67 ± 8 years) and twenty-four cognitively healthy controls (HC) were evaluated. Brain regions with FTD-related glucose hypometabolism in the contrast against HC and brain regions that correlate with the cognitive function were defined by a voxel-based analysis and individual FDG-PET values were extracted from all frontotemporal brain areas. Linear regression analysis served to test if education is associated with residualized cognitive performance and regional FDG-PET hypometabolism after controlling for global cognition.
Compared to healthy controls, patients with FTD showed glucose hypometabolism in bilateral frontal and temporal brain areas whereas cognition was only associated with deteriorated glucose metabolism in the left temporal lobe. The education level was significantly correlated with the residualized cognitive performance (residuals from regression analysis between hypometabolism and cognitive function as a quantitative index of reserve) and also negatively correlated with left temporal FDG-PET hypometabolism after controlling for cognition.
In patients with FTD, the education level predicts the existing left temporal FDG-PET hypometabolism at the same cognition level, supporting the cognitive reserve hypothesis in FTD.
储备被定义为在给定的病理水平上保持认知功能相对良好的能力。一般来说，早期生活经历，如教育，与较低的痴呆风险有关。然而，在大量患者群体中，是否更多年的教育可以防止脑改变对额颞叶痴呆（FTD）的影响尚未得到证明。因此，我们评估了教育是否与相对较高的认知表现相关，尽管 FTD 存在 [F]-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）低代谢。
评估了 66 名 FTD 受试者（年龄 67 ± 8 岁）和 24 名认知健康对照者（HC）。通过基于体素的分析定义了与 HC 相比 FTD 相关的葡萄糖低代谢的脑区和与认知功能相关的脑区，并从所有额颞叶脑区提取了个体 FDG-PET 值。线性回归分析用于测试教育是否与控制整体认知后残差认知表现和区域性 FDG-PET 低代谢相关。
与健康对照组相比，FTD 患者双侧额颞叶脑区葡萄糖代谢降低，而认知仅与左侧颞叶葡萄糖代谢恶化相关。受教育程度与残差认知表现显著相关（残差来自代谢和认知功能之间的回归分析，作为储备的定量指标），并在控制认知后与左侧颞叶 FDG-PET 低代谢呈负相关。
在 FTD 患者中，教育水平预测了相同认知水平下存在的左侧颞叶 FDG-PET 低代谢，支持了 FTD 中的认知储备假说。
