Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China.
Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China.
CNS Neurosci Ther. 2023 Aug;29(8):2193-2205. doi: 10.1111/cns.14169. Epub 2023 Mar 16.
To estimate the proportions of specific hypometabolic patterns and their association with neuropsychiatric symptoms (NPS) in patients with cognitive impairment (CI).
This multicenter study with 1037 consecutive patients was conducted from December 2012 to December 2019. F-FDG PET and clinical/demographic information, NPS assessments were recorded and analyzed to explore the associations between hypometabolic patterns and clinical features by correlation analysis and multivariable logistic regression models.
Patients with clinical Alzheimer's disease (AD, 81.6%, 605/741) and dementia with Lewy bodies (67.9%, 19/28) mostly had AD-pattern hypometabolism, and 76/137 (55.5%) of patients with frontotemporal lobar degeneration showed frontal and anterior temporal pattern (FT-P) hypometabolism. Besides corticobasal degeneration, patients with behavioral variant frontotemporal dementia (36/58), semantic dementia (7/10), progressive non-fluent aphasia (6/9), frontotemporal lobar degeneration and amyotrophic lateral sclerosis (3/5), and progressive supranuclear palsy (21/37) also mostly showed FT-P hypometabolism. The proportion of FT-P hypometabolism was associated with the presence of hallucinations (R = 0.171, p = 0.04), anxiety (R = 0.182, p = 0.03), and appetite and eating abnormalities (R = 0.200, p = 0.01) in AD.
Specific hypometabolic patterns in FDG-PET are associated with NPS and beneficial for the early identification and management of NPS in patients with CI.
评估认知障碍（CI）患者特定低代谢模式的比例及其与神经精神症状（NPS）的关系。
这是一项多中心研究，共纳入 1037 例连续患者，于 2012 年 12 月至 2019 年 12 月进行。记录并分析 F-FDG PET 与临床/人口统计学信息、NPS 评估，以通过相关分析和多变量逻辑回归模型探索低代谢模式与临床特征之间的关系。
81.6%（605/741）的临床阿尔茨海默病（AD）和 67.9%（19/28）的路易体痴呆（DLB）患者主要表现为 AD 型低代谢，76/137（55.5%）的额颞叶变性患者表现为额和前颞叶低代谢模式（FT-P）。除皮质基底节变性外，行为变异型额颞叶痴呆（36/58）、语义性痴呆（7/10）、进行性非流利性失语症（6/9）、额颞叶变性和肌萎缩侧索硬化症（3/5）和进行性核上性麻痹（21/37）患者也主要表现为 FT-P 低代谢。FT-P 低代谢比例与 AD 患者幻觉（R=0.171，p=0.04）、焦虑（R=0.182，p=0.03）和食欲和饮食异常（R=0.200，p=0.01）有关。
FDG-PET 中的特定低代谢模式与 NPS 相关，有助于早期识别和管理 CI 患者的 NPS。
