Qiao Zhen, Wang Guihong, Zhao Xiaobin, Wang Kai, Fan Di, Chen Qian, Ai Lin
Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Aging Neurosci. 2022 May 18;14:841942. doi: 10.3389/fnagi.2022.841942. eCollection 2022.
This study characterizes glucose metabolism and tau protein deposition distribution in patients with Alzheimer's disease (AD) and to evaluate the relationships between neuropsychological performance and tau protein deposition or glucose metabolism using F-FDG and F-AV1451 positron emission tomography/computed tomography (PET/CT).
Sixty-four patients with β-amyloid-positive (Aβ+) AD and twenty-five healthy participants were enrolled in this study. All participants underwent F-FDG and F-AV1451 PET/CT. Clinical data and neuropsychological scores were collected. Patients with AD were divided into mild, moderate, and severe groups according to mini-mental state examination (MMSE) scores. The standardized uptake value ratios (SUVRs) for both FDG and AV1451 PET images were calculated using the cerebellar vermis as reference. The SUVRs of the whole cerebral cortex and each brain region were calculated. The volume of interest (VOI) was obtained using automated anatomical atlas (AAL) and Brodmann regions. Student's -test was used to perform intergroup comparisons of SUVR. The partial correlation coefficient between SUVR and neuropsychological scores was computed in an inter-subject manner using age and education as covariates.
The mild subgroup showed a reduction in glucose metabolism and aggregation of tau protein in the temporoparietal cortex. With a decline in neuropsychiatric performance, the SUVR on FDG PET decreased and SUVR on tau PET increased gradually. The areas of glucose metabolism reduction and tau protein deposition appeared first in the parietal cortex, followed by the temporal and frontal cortex, successively. Both FDG and tau SUVRs significantly correlated with MMSE, Montreal cognitive assessment (MOCA), auditory verbal learning test (AVLT), Boston naming test (BNT), clock drawing task (CDT), and verbal fluency test (VFT) ( < 0.05). The SUVR on FDG PET significantly correlated with activities of daily living (ADL) and the Hamilton depression scale (HAMD). There was no significant correlation between the tau SUVRs and ADL or HAMD.
The extension of tau protein deposition was similar but not exactly consistent with the area of glucose metabolism reduction. Both tau and FDG SUVRs correlated with cognitive function in domain-specific patterns, and the results of FDG PET more closely correlated with neuropsychological function than tau PET results did.
本研究旨在描述阿尔茨海默病（AD）患者的葡萄糖代谢及tau蛋白沉积分布特征，并使用氟代脱氧葡萄糖（F-FDG）和氟代-AV1451正电子发射断层扫描/计算机断层扫描（PET/CT）评估神经心理学表现与tau蛋白沉积或葡萄糖代谢之间的关系。
本研究纳入了64例β淀粉样蛋白阳性（Aβ+）的AD患者和25名健康参与者。所有参与者均接受了F-FDG和F-AV1451 PET/CT检查。收集了临床数据和神经心理学评分。AD患者根据简易精神状态检查表（MMSE）评分分为轻度、中度和重度组。以小脑蚓部为参照计算FDG和AV1451 PET图像的标准化摄取值比率（SUVRs）。计算全脑皮质及每个脑区的SUVRs。使用自动解剖图谱（AAL）和布罗德曼区域获取感兴趣区（VOI）。采用学生t检验进行SUVR的组间比较。以年龄和教育程度作为协变量，以受试者间方式计算SUVR与神经心理学评分之间的偏相关系数。
轻度亚组显示颞顶叶皮质葡萄糖代谢降低及tau蛋白聚集。随着神经精神表现的下降，FDG PET上的SUVR降低，tau PET上的SUVR逐渐升高。葡萄糖代谢降低区域和tau蛋白沉积首先出现在顶叶皮质，随后依次为颞叶和额叶皮质。FDG和tau SUVRs均与MMSE、蒙特利尔认知评估（MOCA）、听觉词语学习测试（AVLT）、波士顿命名测试（BNT）、画钟试验（CDT）和语言流畅性测试（VFT）显著相关（P<0.05）。FDG PET上的SUVR与日常生活活动能力（ADL）和汉密尔顿抑郁量表（HAMD）显著相关。tau SUVRs与ADL或HAMD之间无显著相关性。
tau蛋白沉积的扩展与葡萄糖代谢降低区域相似但不完全一致。tau和FDG SUVRs均以区域特异性模式与认知功能相关，且FDG PET结果与神经心理学功能的相关性比tau PET结果更密切。
