認知症症候群におけるアミロイドPET陽性の流行:メタ解析
Rik Ossenkoppele1, Willemijn J Jansen2, Gil D Rabinovici3
1Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands 3Memory and Aging Center, University of Californ.
JAMA
|May 20, 2015
まとめ
アミロイドβPET画像は,認知症のタイプ,年齢,APOE ε4の状態によってプラークの有病率が異なることを示しています. これは,認知症症候群,特に高齢の非キャリアにおけるアルツハイマー病 (AD) の差別診断の可能性を強調しています.
科学分野:
- 神経学 神経学とは
- 放射線学 放射線学
- 遺伝学 遺伝学とは
背景:
- アミロイドβポジトロン放出トモグラフィー (PET) は,アルツハイマー病 (AD) の特徴である線維性プラークを検出します.
- アミロイドPETの診断価値は,AD以外の認知症でもプラークが現れるため,限られています.
- 個別参加者のデータのメタ解析は,さまざまな認知症タイプにおけるアミロイドPETの流行を理解するために重要である.
研究 の 目的:
- 様々な認知症症候群におけるPETを用いたアミロイド陽性の有病率を推定する.
- アミロイドPET陽性性に対する年齢とアポリポプロテインE (APOE) ε4ステータスの影響を調査する.
- 認知症診断の差別化におけるアミロイドPETの有用性を評価する.
主な方法:
- アミロイドPET研究 (2004年−2015年) の個々の参加者のデータのメタ分析.
- 臨床的に認知症と診断されたADを患った1359人の参加者と,AD以外の認知症を患った538人の参加者のデータを含めた.
- 診断,年齢,APOE ε4 ステータスに基づいて流行をモデル化するために使用される一般的な推定方程式.
主要な成果:
- アミロイド陽性の確率は,ADとAD以外の認知症の両方で,年齢とAPOE ε4状態と相関しています.
- AD認知症では,年齢とともに陽性性が低下し,特にAPOE ε4の非キャリアでは減少した.
- AD以外の認知症では,アミロイド陽性性は一般的に年齢とともに増加し,APOE ε4キャリアである.
結論:
- 認知症の診断,年齢,およびAPOE遺伝子型は,アミロイドPET陽性性に著しく影響します.
- アミロイドPETは,早期発症の認知症の差異診断の可能性を示しています.
- 発見は,APOE ε4のキャリアでない高齢者のAD診断を助けるためにアミロイドPETを使用することを支持しています.
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