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一项关于脑血流量与简易精神状态检查表预测临床前阿尔茨海默病淀粉样蛋白沉积的初步研究。

A Pilot Study on Cerebral Blood Flow and Mini-Mental State Examination to Predict Amyloid Deposition in Preclinical Alzheimer's Disease.

作者信息

Hirose Takumi, Takayama Toshiki, Shibata Nobuto, Murakami Koji, Arai Heii

机构信息

Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Juntendo University, Tokyo, Japan.

Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Psychiatry Clin Psychopharmacol. 2023 Mar 1;33(1):1-7. doi: 10.5152/pcp.2023.22524. eCollection 2023 Mar.

Abstract

BACKGROUND

Earlier differential diagnosis of dementia remains a major challenge. Although amyloid deposition by positron emission tomography is an emerging standard for the diagnosis of Alzheimer's disease, it is too expensive for routine use in clinical settings. We conducted a pilot study on the potential usefulness of single-photon emission computed tomography and the Mini-Mental State Examination to predict amyloid positron emission tomography positivity in preclinical Alzheimer's disease.

METHODS

Eighteen subjects, including 11 with mild cognitive impairment and 7 with subjective cognitive decline, underwent F-florbetapir positron emission tomography, Tc-ethylcysteinate dimer cerebral perfusion single-photon emission computed tomography, and the Mini-Mental State Examination. For the assessment of amyloid deposition, visual judgment as a qualitative method and a semiautomatic software analysis as a quantitative method were used.

RESULTS

Six subjects were judged as amyloid positive, including 4 mild cognitive impairment and 2 subjective cognitive decline subjects. Compared to the amyloid positron emission tomography-negative group, this group showed a statistically significant difference in the Mini-Mental State Examination recall score [2 (1 : 3) vs. 3 (2 : 3),  = .041] and single-photon emission computed tomography findings from the amyloid-negative group. In the mild cognitive impairment subgroup, correlations were found between amyloid deposition and single-photon emission computed tomography indicators, while in the subjective cognitive decline subgroup, only the Mini-Mental State Examination recall score correlated with amyloid deposition.

CONCLUSION

The Mini-Mental State Examination recall score and single-photon emission computed tomography indicators may be worthwhile for further evaluation as predictors of amyloid deposition in the preclinical stage.

摘要

背景

早期鉴别诊断痴呆症仍然是一项重大挑战。尽管正电子发射断层扫描显示的淀粉样蛋白沉积是诊断阿尔茨海默病的一项新兴标准,但在临床环境中常规使用成本过高。我们开展了一项关于单光子发射计算机断层扫描和简易精神状态检查表预测临床前阿尔茨海默病淀粉样蛋白正电子发射断层扫描阳性的潜在效用的试点研究。

方法

18名受试者,包括11名轻度认知障碍患者和7名主观认知功能减退患者,接受了F-氟比他哌正电子发射断层扫描、锝-乙胱氨酸二聚体脑灌注单光子发射计算机断层扫描以及简易精神状态检查表检查。对于淀粉样蛋白沉积的评估,采用视觉判断作为定性方法,半自动软件分析作为定量方法。

结果

6名受试者被判定为淀粉样蛋白阳性,包括4名轻度认知障碍患者和2名主观认知功能减退患者。与淀粉样蛋白正电子发射断层扫描阴性组相比,该组在简易精神状态检查表回忆得分[2(1:3)对3(2:3),P = 0.041]以及与淀粉样蛋白阴性组相比的单光子发射计算机断层扫描结果方面存在统计学显著差异。在轻度认知障碍亚组中,发现淀粉样蛋白沉积与单光子发射计算机断层扫描指标之间存在相关性,而在主观认知功能减退亚组中,只有简易精神状态检查表回忆得分与淀粉样蛋白沉积相关。

结论

简易精神状态检查表回忆得分和单光子发射计算机断层扫描指标作为临床前阶段淀粉样蛋白沉积的预测指标可能值得进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843d/11082584/f1300e73518e/pcp-33-1-1_f001.jpg

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