Vander Borght T, Minoshima S, Giordani B, Foster N L, Frey K A, Berent S, Albin R L, Koeppe R A, Kuhl D E
Division of Nuclear Medicine, University of Michigan Medical School, USA.
J Nucl Med. 1997 May;38(5):797-802.
Despite controversial clinicopathological distinctions between Parkinson's disease with dementia (PDD) and Alzheimer's disease (AD), similar patterns of metabolic reduction in the posterior brain were reported previously using PET with [18F]fluorodeoxyglucose. The current study was designed to examine more specific regional differences in cerebral glucose metabolism between PDD and AD using accurate and objective brain mapping techniques.
This study included nine normal subjects, nine PDD patients and nine AD patients. PDD and AD groups were matched carefully for age, sex and general dementia severity as measured by Mini-Mental State Examination and Clinical Dementia Rating scales. Each subject underwent [18F]fluorodeoxyglucose-PET and neuropsychological testing. After anatomic standardization of PET image sets and stereotactic data extraction, absolute and normalized cerebral metabolic rates were assessed by region of interest and pixel-by-pixel analyses.
PDD and AD showed global glucose metabolic reduction with similar regional accentuation involving the lateral parietal, lateral temporal and lateral frontal association cortices and posterior cingulate cortex in comparison to normal controls. When comparing between PDD and AD, however, PDD showed greater metabolic reduction in the visual cortex and relatively preserved metabolism in the medial temporal cortex.
Although a common feature of metabolic abnormalities in the posterior brain exists in PDD and AD, the presence of regional metabolic differences suggests different degrees and combinations of disease specific underlying pathological and neurochemical processes.
尽管帕金森病痴呆（PDD）和阿尔茨海默病（AD）在临床病理特征上存在争议，但先前使用[18F]氟脱氧葡萄糖PET报告了后脑代谢降低的相似模式。本研究旨在使用准确且客观的脑图谱技术，检查PDD和AD之间脑葡萄糖代谢更具体的区域差异。
本研究纳入9名正常受试者、9名PDD患者和9名AD患者。根据简易精神状态检查表和临床痴呆评定量表测量的年龄、性别和总体痴呆严重程度，对PDD组和AD组进行仔细匹配。每位受试者均接受[18F]氟脱氧葡萄糖PET检查和神经心理学测试。在对PET图像集进行解剖标准化和立体定向数据提取后，通过感兴趣区域和逐像素分析评估绝对和标准化脑代谢率。
与正常对照组相比，PDD和AD均表现出整体葡萄糖代谢降低，且在外侧顶叶、外侧颞叶和外侧额叶联合皮质以及后扣带回皮质存在相似的区域强化。然而，在比较PDD和AD时，PDD在视觉皮质表现出更大程度的代谢降低，而内侧颞叶皮质的代谢相对保留。
尽管PDD和AD在后脑存在代谢异常的共同特征，但区域代谢差异表明疾病特异性潜在病理和神经化学过程的程度和组合不同。
