Kim Ji Eun, Lee Dong-Kyun, Hwang Ji Hye, Kim Chan-Mi, Kim Yeji, Lee Jae-Hong, Lee Jong-Min, Roh Jee Hoon
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Department of Neurology, Inje University Ilsan Paik Hospital, Goyang 10380, Korea.
Exp Neurobiol. 2022 Dec 31;31(6):401-408. doi: 10.5607/en22022.
Striatal changes in the pathogenesis of Alzheimer's disease (AD) is not fully understood yet. We compared structural and functional image differences in the striatum between patients with early onset AD (EOAD) and late onset AD (LOAD) to investigate whether EOAD harbors autosomal dominant AD like imaging findings. The clinical, neuropsychological and neuroimaging biomarkers of 77 probable AD patients and 107 elderly subjects with normal cognition (NC) from the Alzheimer's Disease Neuroimaging Initiative (ADNI)-2 dataset were analyzed. Enrolled each subject completed a 3-Tesla MRI, baseline 18F-FDG-PET, and baseline 18F-AV-45 (Florbetapir) amyloid PET studies. AD patients were divided into two groups based on the onset age of clinical symptoms (EOAD <65 yrs; LOAD ≥65 yrs). A standardized uptake value ratio of the striatum and subcortical structures was obtained from both amyloid and FDG-PET scans. Structural MR imaging analysis was conducted using a parametric boundary description protocol, SPHARM-PDM. Of the 77 AD patients, 18 were EOAD and 59 were LOAD. Except for age of symptom onset, there were no statistically significant differences between the groups in demographics and detailed neuropsychological test results. 18F-AV-45 amyloid PET showed marked β-amyloid accumulation in the bilateral caudate nucleus and left pallidum in the EOAD group. Intriguingly, the caudate nucleus and putamen showed maintained glucose metabolism in the EOAD group compared to the LOAD group. Our image findings in the striatum of EOAD patients suggest that sporadic EOAD may share some pathophysiological changes noted in autosomal dominant AD.
纹状体在阿尔茨海默病（AD）发病机制中的变化尚未完全明确。我们比较了早发型AD（EOAD）和晚发型AD（LOAD）患者纹状体的结构和功能影像差异，以研究EOAD是否具有常染色体显性AD样的影像学表现。分析了来自阿尔茨海默病神经影像倡议（ADNI）-2数据集的77例可能的AD患者和107例认知正常（NC）的老年受试者的临床、神经心理学和神经影像学生物标志物。纳入的每位受试者均完成了3特斯拉MRI、基线18F-FDG-PET和基线18F-AV-45（氟代贝他吡）淀粉样蛋白PET研究。AD患者根据临床症状的发病年龄分为两组（EOAD<65岁；LOAD≥65岁）。从淀粉样蛋白和FDG-PET扫描中获得纹状体和皮质下结构的标准化摄取值比率。使用参数化边界描述协议SPHARM-PDM进行结构磁共振成像分析。77例AD患者中，18例为EOAD，59例为LOAD。除症状发病年龄外，两组在人口统计学和详细神经心理学测试结果方面无统计学显著差异。18F-AV-45淀粉样蛋白PET显示EOAD组双侧尾状核和左侧苍白球有明显的β淀粉样蛋白积聚。有趣的是，与LOAD组相比，EOAD组的尾状核和壳核葡萄糖代谢维持正常。我们对EOAD患者纹状体的影像研究结果表明，散发性EOAD可能具有一些常染色体显性AD中所发现的病理生理变化。
