Xiong Min, You Hongji, Liao Wang, Mai Yingren, Luo Xiaoming, Liu Yipei, Jiang Sheng-Nan
Department of Nuclear Medicine, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Department of Neurology, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
J Alzheimers Dis Rep. 2024 Sep 5;8(1):1229-1240. doi: 10.3233/ADR-240104. eCollection 2024.
F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) is valuable in Alzheimer's disease (AD) workup.
To explore the effectiveness of F-FDG PET in differentiating and staging AD and associations between brain glucose metabolism and cognitive functions and vascular risk factors.
107 participates including 19 mild cognitive impairment (MCI), 38 mild AD, 24 moderate AD, 15 moderate-severe AD, and 11 frontotemporal dementia (FTD) were enrolled. Visual and voxel-based analysis procedures were utilized. Cognitive conditions, including 6 cognitive function scores and 7 single-domain cognitive performances, and vascular risk factors linked to hypertension, hyperlipidemia, diabetes, and obesity were correlated with glucose metabolism in AD dementia using age as a covariate.
F-FDG PET effectively differentiated AD from FTD and also differentiated MCI from AD subtypes with significantly different hypometabolism (except for mild AD) (height threshold < 0.001, all < 0.05, the same below). The cognitive function scores, notably Mini-Mental State Examination and Montreal Cognitive Assessment, correlated significantly with regional glucose metabolism in AD participants (all < 0.05), whereas the single-domain cognitive performance and vascular risk factors were significantly associated with regional glucose metabolism in MCI patients (all < 0.05).
This study underlines the vital role of F-FDG PET in identifying and staging AD. Brain glucose metabolism is associated with cognitive status in AD dementia and vascular risk factors in MCI, indicating that F-FDG PET might be promising for predicting cognitive decline and serve as a visual framework for investigating underlying mechanism of vascular risk factors influencing the conversion from MCI to AD.
氟脱氧葡萄糖（F-FDG）正电子发射断层扫描（PET）在阿尔茨海默病（AD）检查中具有重要价值。
探讨F-FDG PET在AD鉴别与分期中的有效性，以及脑葡萄糖代谢与认知功能和血管危险因素之间的关联。
纳入107名参与者，包括19名轻度认知障碍（MCI）、38名轻度AD、24名中度AD、15名中度至重度AD和11名额颞叶痴呆（FTD）患者。采用视觉分析和基于体素的分析程序。以年龄作为协变量，将认知状况（包括6项认知功能评分和7项单领域认知表现）以及与高血压、高脂血症、糖尿病和肥胖相关的血管危险因素与AD痴呆患者的葡萄糖代谢进行关联分析。
F-FDG PET能有效区分AD与FTD，也能区分MCI与不同AD亚型，且代谢减低差异显著（轻度AD除外）（高度阈值<0.001，均<0.05，下同）。认知功能评分，尤其是简易精神状态检查表和蒙特利尔认知评估量表，与AD参与者的区域葡萄糖代谢显著相关（均<0.05），而单领域认知表现和血管危险因素与MCI患者的区域葡萄糖代谢显著相关（均<0.05）。
本研究强调了F-FDG PET在AD识别与分期中的重要作用。脑葡萄糖代谢与AD痴呆的认知状态以及MCI的血管危险因素相关，表明F-FDG PET在预测认知衰退方面可能具有前景，并可作为研究血管危险因素影响MCI向AD转化潜在机制的可视化框架。
