Chen Qin, Lowe Val J, Boeve Bradley F, Przybelski Scott A, Miyagawa Toji, Senjem Matthew L, Jack Clifford R, Lesnick Timothy G, Kremers Walter K, Fields Julie A, Min Hoon-Ki, Schwarz Christopher G, Gunter Jeffrey L, Graff-Radford Jonathan, Savica Rodolfo, Knopman David S, Jones David, Ferman Tanis J, Graff-Radford Neill R, Petersen Ronald C, Kantarci Kejal
From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL.
Neurology. 2021 Feb 22;96(8):e1180-e1189. doi: 10.1212/WNL.0000000000011454.
To determine the clinical phenotypes associated with the β-amyloid PET and dopamine transporter imaging (I-FP-CIT SPECT) findings in mild cognitive impairment (MCI) with the core clinical features of dementia with Lewy bodies (DLB; MCI-LB).
Patients with MCI who had at least 1 core clinical feature of DLB (n = 34) were grouped into β-amyloid A+ or A- and I-FP-CIT SPECT D+ or D- groups based on previously established abnormality cut points for A+ with Pittsburgh compound B PET standardized uptake value ratio (PiB SUVR) ≥1.48 and D+ with putamen score with DaTQUANT <-0.82 on I-FP-CIT SPECT. Individual patients with MCI-LB fell into 1 of 4 groups: A+D+, A+D-, A-D+, or A-D-. Log-transformed PiB SUVR and putamen score were tested for associations with patient characteristics.
The A-D+ biomarker profile was most common (38.2%), followed by A+D+ (26.5%) and A-D- (26.5%). The least common was the A+D- biomarker profile (8.8%). The A+ group was older, had a higher frequency of ε4 carriers, and had a lower Mini-Mental State Examination score than the A- group. The D+ group was more likely to have probable REM sleep behavior disorder. Lower putamen DaTQUANT scores and lower PiB SUVRs were independently associated with higher Unified Parkinson's Disease Rating Scale-III scores.
A majority of patients with MCI-LB are characterized by low β-amyloid deposition and reduced dopaminergic activity. β-Amyloid PET and I-FP-CIT SPECT are complementary in characterizing clinical phenotypes of patients with MCI-LB.
确定伴有路易体痴呆（DLB；MCI-LB）核心临床特征的轻度认知障碍（MCI）患者中，与β淀粉样蛋白PET及多巴胺转运体成像（I-FP-CIT SPECT）结果相关的临床表型。
具有至少1项DLB核心临床特征的MCI患者（n = 34），根据先前确定的异常切点，基于匹兹堡化合物B PET标准化摄取值比率（PiB SUVR）≥1.48将其分为β淀粉样蛋白A+或A-组，基于I-FP-CIT SPECT上壳核评分DaTQUANT＜-0.82将其分为D+或D-组。MCI-LB的个体患者分为4组之一：A+D+、A+D-、A-D+或A-D-。对经对数转换的PiB SUVR和壳核评分进行测试，以确定其与患者特征的相关性。
A-D+生物标志物特征最为常见（38.2%），其次是A+D+（26.5%）和A-D-（26.5%）。最不常见的是A+D-生物标志物特征（8.8%）。A+组患者年龄更大，ε4携带者频率更高，简易精神状态检查表评分低于A-组。D+组更有可能出现可能的快速眼动睡眠行为障碍。壳核DaTQUANT评分较低和PiB SUVR较低与较高的统一帕金森病评定量表III评分独立相关。
大多数MCI-LB患者的特征是β淀粉样蛋白沉积低和多巴胺能活性降低。β淀粉样蛋白PET和I-FP-CIT SPECT在表征MCI-LB患者的临床表型方面具有互补性。
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