From the Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China (Liu, Chu, Xie, Cui, Jiang, Chen, Nan, Wu); the Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China (Yan, Lu); the Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China (Nie); the School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, China (Nie); the McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Montreal, Que. (Rosa-Neto); the Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China (Lu).
From the Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China (Liu, Chu, Xie, Cui, Jiang, Chen, Nan, Wu); the Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China (Yan, Lu); the Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China (Nie); the School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing, China (Nie); the McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Montreal, Que. (Rosa-Neto); the Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China (Lu)
J Psychiatry Neurosci. 2023 Apr 12;48(2):E126-E134. doi: 10.1503/jpn.220164. Print 2023 Mar-Apr.
There is growing evidence that the striatum plays a central role in cognitive dysfunction. However, it remains unclear whether and how the striatum contributes specifically to executive deficits in Alzheimer disease (AD). We sought to elucidate aberrations in the striatal subregion associated with executive function and its metabolic connectivity with the cortical regions to investigate its role in the pathogenesis of executive deficits in patients with AD.
Patients with AD and healthy controls underwent a neuropsychological assessment battery, including assessment of executive function, and a hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) scan. We performed voxel-wise analyses of cerebral metabolism between patients and controls, focusing on the executive subregion of the striatum according to the Oxford-GSK-Imanova Striatal Connectivity Atlas. We assessed the correlation between the [F]-fluorodeoxyglucose standardized uptake value ratio of the striatal executive subregion and clinical variables, and we analyzed seed-based metabolic connectivity of the striatal executive subregion with the dorsolateral prefrontal cortex (DLPFC) using [F]-fluorodeoxyglucose PET.
We included 50 patients with AD and 33 controls in our analyses. The patterns of striatal hypometabolism in patients with AD were specific to executive and caudal motor subregions. Metabolic activity in the executive subregion of the striatum correlated negatively with the severity of executive dysfunction, as measured with the Trial-Making Test (TMT) part B and the difference score TMT B-A, and correlated positively with Digit Span (backward) and Verbal Fluency Test scales, particularly on the left side. Compared with controls, patients with AD showed reduced metabolic connectivity between striatal executive subregions and the dorsolateral prefrontal cortex (DLPFC).
Our study was limited by small sample sizes and cross-sectional findings.
Our findings show that patients with AD have impairments in the executive subregion of the striatum, and these deficits may be associated with a disconnection between the executive striatum and DLPFC, providing valuable insight into the pathogenesis of this disease.
越来越多的证据表明纹状体在认知功能障碍中起着核心作用。然而，目前尚不清楚纹状体是否以及如何专门导致阿尔茨海默病（AD）患者的执行功能缺陷。我们试图阐明与执行功能相关的纹状体亚区的异常及其与皮质区域的代谢连接，以研究其在 AD 患者执行功能缺陷发病机制中的作用。
AD 患者和健康对照者接受神经心理学评估，包括执行功能评估和正电子发射断层扫描/磁共振成像（PET/MRI）混合扫描。我们对患者和对照组之间的大脑代谢进行了体素分析，根据牛津- GSK-Imanova 纹状体连接图谱，重点关注纹状体的执行亚区。我们评估了纹状体执行亚区的[F]-氟脱氧葡萄糖标准化摄取值比值与临床变量之间的相关性，并使用[F]-氟脱氧葡萄糖 PET 分析了纹状体执行亚区与背外侧前额叶皮层（DLPFC）的种子代谢连接。
我们的分析纳入了 50 名 AD 患者和 33 名对照者。AD 患者的纹状体代谢低下模式与执行和尾部运动亚区有关。纹状体执行亚区的代谢活性与执行功能障碍的严重程度呈负相关，这与连线测试（TMT）部分 B 和 TMT B-A 的差值以及数字跨度（后向）和言语流畅性测试量表相关，尤其是在左侧。与对照组相比，AD 患者的纹状体执行亚区与背外侧前额叶皮层（DLPFC）之间的代谢连接减少。
我们的研究受到样本量小和横断面发现的限制。
我们的研究结果表明，AD 患者的纹状体执行亚区存在功能障碍，这些缺陷可能与执行纹状体与 DLPFC 之间的连接中断有关，为该疾病的发病机制提供了有价值的见解。
