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Published on: December 28, 2014
Subcortical vascular versus amnestic mild cognitive impairment: comparison of cerebral glucose metabolism
Sang Won Seo1, Sang Soo Cho, Aram Park
1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Background And Purpose:
Most studies on mild cognitive impairment (MCI) have been focused on amnestic MCI (aMCI) that is the preclinical stage of Alzheimer's disease (AD). In contrast, only a few studies have involved patients in the preclinical stages of subcortical vascular dementia (subcortical vascular MCI, svMCI). We tried to compare the overall glucose metabolism in patients with svMCI with that of patients with aMCI.
Methods:
We compared the regional metabolic patterns shown on 18 F-FDG (fluro deoxy glucose) positron emission tomography (PET) images from 18 patients with svMCI with those from 25 aMCI patients matched for age, sex, education, and mini-mental state examination (MMSE) score and with those from 35 healthy subjects using a voxel-wise analysis. SPM 2 was used for statistical analysis.
Results:
Relative to normal controls, the hypometabolic regions in the aMCI patients were in the bilateral parahippocampal, bilateral posterior cingulate, left superior temporal gyri, left inferior parietal lobule, and right inferior frontal gyrus while those in the svMCI patients were located in the thalamus, insula, superior temporal gyrus, anterior cingulate gyrus, cingulum, right basal ganglia, cerebellum, and brainstem. A direct comparison of glucose metabolism between svMCI and aMCI showed that the glucose hypometabolism in patients with svMCI was more severe in the thalamus, brainstem, and cerebellum.
Conclusion:
Our study suggested that svMCI was distinct from aMCI in terms of neuropsychological and PET findings, which may explain their clinical manifestations.
Insights
Subcortical vascular MCI (svMCI) shows distinct brain glucose metabolism patterns compared to amnestic MCI (aMCI). PET imaging reveals significant differences in hypometabolism, particularly in the thalamus, brainstem, and cerebellum for svMCI patients.
Area of Science:
- Neuroimaging
- Neurology
- Metabolic Disorders
Background:
- Mild cognitive impairment (MCI) research predominantly focuses on amnestic MCI (aMCI), a precursor to Alzheimer's disease (AD).
- Subcortical vascular MCI (svMCI), a less-studied preclinical stage of vascular dementia, requires further investigation.
- Understanding metabolic differences is crucial for accurate diagnosis and management of MCI subtypes.
Purpose of the Study:
- To compare the overall glucose metabolism patterns between patients with svMCI and aMCI.
- To identify distinct neuroimaging biomarkers for differentiating svMCI from aMCI.
- To elucidate the underlying pathophysiology of svMCI using positron emission tomography (PET).
Main Methods:
- 18F-fluorodeoxyglucose (FDG) PET imaging was used to assess regional glucose metabolism.
- Voxel-wise analysis compared metabolic patterns in 18 svMCI patients, 25 aMCI patients, and 35 healthy controls.
- Patients were matched for age, sex, education, and Mini-Mental State Examination (MMSE) scores.
Main Results:
- aMCI patients exhibited hypometabolism in the parahippocampal gyri, posterior cingulate, and temporal/parietal/frontal lobes.
- svMCI patients showed hypometabolism in the thalamus, insula, cingulate gyrus, basal ganglia, cerebellum, and brainstem.
- Direct comparison revealed more severe hypometabolism in the thalamus, brainstem, and cerebellum in svMCI compared to aMCI.
Conclusions:
- svMCI is neurobiologically distinct from aMCI, as evidenced by differing patterns of glucose hypometabolism.
- These PET findings correlate with distinct neuropsychological profiles, aiding in clinical differentiation.
- The study highlights the utility of FDG-PET in characterizing MCI subtypes and their underlying pathologies.
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