Liu Meichen, Xie Xueting, Xie Jinghui, Tian Shiyun, Du Xuemei, Feng Hongbo, Zhang Huimin
Department of Neurology, The First Affiliated Hospital, Dalian Medical University, Dalian, China.
Department of Nuclear Medicine, The First Affiliated Hospital, Dalian Medical University, Dalian, China.
Front Psychiatry. 2023 Apr 27;14:1192562. doi: 10.3389/fpsyt.2023.1192562. eCollection 2023.
Alzheimer's disease is a common neurodegenerative disease, and patients with early-onset Alzheimer's disease (onset age < 65 years) often have atypical symptoms, which are easily misdiagnosed and missed. Multimodality neuroimaging has become an important diagnostic and follow-up method for AD with its non-invasive and quantitative advantages.
We report a case of a 59-year-old female with a diagnosis of depression at the age of 50 after a 46-year-old onset and a 9-year follow-up observation, who developed cognitive dysfunction manifested by memory loss and disorientation at the age of 53, and eventually developed dementia. Combined with neuropsychological scales (MMSE and MOCA scores decreased year by year and finally reached the dementia criteria) and the application of multimodal imaging. MRI showed that the hippocampus atrophied year by year and the cerebral cortex was extensively atrophied. 18F-FDG PET image showed hypometabolism in right parietal lobes, bilateral frontal lobes, bilateral joint parieto-temporal areas, and bilateral posterior cingulate glucose metabolism. The 18F-AV45 PET image showed the diagnosis of early-onset Alzheimer's disease was confirmed by the presence of Aβ deposits in the cerebral cortex.
Early-onset Alzheimer's disease, which starts with depression, often has atypical symptoms and is prone to misdiagnosis. The combination of neuropsychological scales and neuroimaging examinations are good screening tools that can better assist in the early diagnosis of Alzheimer's disease. Graphical Abstract.
阿尔茨海默病是一种常见的神经退行性疾病，早发性阿尔茨海默病（发病年龄＜65岁）患者常出现非典型症状，易被误诊和漏诊。多模态神经影像学检查以其无创、定量的优势，已成为阿尔茨海默病重要的诊断及随访手段。
我们报告一例59岁女性患者，50岁时因发病46年后被诊断为抑郁症并进行了9年的随访观察，53岁时出现以记忆力减退和定向障碍为表现的认知功能障碍，最终发展为痴呆。结合神经心理量表（MMSE和MOCA评分逐年下降，最终达到痴呆标准）及多模态影像学检查。MRI显示海马体逐年萎缩，大脑皮质广泛萎缩。18F-FDG PET图像显示右侧顶叶、双侧额叶、双侧顶颞联合区及双侧后扣带回葡萄糖代谢减低。18F-AV45 PET图像显示大脑皮质存在Aβ沉积，确诊为早发性阿尔茨海默病。
以抑郁症起病的早发性阿尔茨海默病常具有非典型症状，易误诊。神经心理量表与神经影像学检查相结合是较好的筛查工具，能更好地辅助阿尔茨海默病的早期诊断。图形摘要。
