Saleh Nouredine, Blaise Capucine, Daoudi Amina, Queneau Matthieu, Fard Karim, Dumurgier Julien, Munoz-Musat Esteban, Marlinge Emeline, Hugon Jacques, Hourregue Claire, Paquet Claire, Cognat Emmanuel
Department of nuclear medicine, Centre de Neurologie Cognitive, GHU AP-HP.Nord, Site Lariboisière Fernand-Widal, 200 rue du Faubourg Saint-Denis, Paris, 75010, France.
Université Paris Cité, UMRS 1144, INSERM, Paris, France.
Int J Bipolar Disord. 2024 Dec 31;12(1):45. doi: 10.1186/s40345-024-00366-3.
Patients with bipolar disorder (BD) are at increased risk of dementia. The underlying mechanisms are debated. FDG-PET elucidates glucose metabolic reductions due to altered neuronal activity in the cerebral cortex, allowing detection and identification of neurodegenerative processes. This study aims to investigate cerebral glucose metabolism in cognitively impaired elderly patients with BD using FDG-PET imaging, to elucidate potential underlying mechanisms and improve diagnostic accuracy.
We conducted a retrospective analysis of FDG-PET scans from 32 cognitively impaired elderly patients with BD (mean age 70.4 years). These were compared with scans from 35 non-degenerative controls (NDC) and patients diagnosed with Alzheimer's disease (AD, n = 27), frontotemporal dementia (FTD, n = 26), and dementia with Lewy bodies (DLB, n = 18). Voxel-wise statistical analysis was performed using SPM software, adjusting for age and sex.
No significant cortical hypometabolism was found in patients with BD compared to NDC. In contrast, typical patterns of hypometabolism were observed in the AD, FTD, and DLB groups. The findings suggest that late-life cognitive impairment in patients with BD is not due to a single common neurodegenerative process.
The absence of abnormal cortical metabolism in cognitively impaired elderly patients with BD suggests that cognitive impairment in this population may not be driven by a common neurodegenerative pathway. Further studies using other biomarkers are needed to investigate the brain processes involved, which could lead to improved understanding and management of cognitive impairment in patients with BD.
双相情感障碍（BD）患者患痴呆症的风险增加。其潜在机制存在争议。氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）可阐明由于大脑皮层神经元活动改变导致的葡萄糖代谢降低情况，有助于检测和识别神经退行性过程。本研究旨在使用FDG-PET成像研究认知受损的老年BD患者的脑葡萄糖代谢，以阐明潜在的潜在机制并提高诊断准确性。
我们对32名认知受损的老年BD患者（平均年龄70.4岁）的FDG-PET扫描进行了回顾性分析。将这些扫描结果与35名非退行性对照（NDC）以及被诊断为阿尔茨海默病（AD，n = 27）、额颞叶痴呆（FTD，n = 26）和路易体痴呆（DLB，n = 18）患者的扫描结果进行比较。使用统计参数映射（SPM）软件进行体素水平的统计分析，并对年龄和性别进行校正。
与NDC相比，BD患者未发现明显的皮质代谢减退。相比之下，在AD、FTD和DLB组中观察到了典型的代谢减退模式。这些发现表明，BD患者的晚年认知障碍并非由单一的常见神经退行性过程所致。
认知受损的老年BD患者不存在异常的皮质代谢，这表明该人群的认知障碍可能不是由常见的神经退行性途径驱动的。需要使用其他生物标志物进行进一步研究，以调查所涉及的脑过程，这可能有助于更好地理解和管理BD患者的认知障碍。
