在后皮层缩和早期发作的典型阿尔茨海默病的表型特异性代谢模式
Jiaying Lu1,2, Keliang Chen2,3, Huamei Lin1
1Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No.518, East Wuzhong Road, Shanghai, 200235, China.
Annals of nuclear medicine
|February 28, 2025
概括
后皮层缩 (PCA) 的代谢模式与典型的早期阿尔茨海默病 (AD) 完全不同. 与PCA相关的模式 (PCARP) 有效地将PCA与其他神经退行性疾病区分开来,并且与临床严重程度相关.
科学领域:
- 神经成像是一种神经成像.
- 神经学 神经学
- 代谢成像 - 代谢成像
背景情况:
- 后皮层缩 (PCA) 是一种非典型的阿尔茨海默病 (AD) 变体,由于症状异质性,它经常带来诊断挑战.
- 早期发病的AD (EOAD) 包括典型的AD (tAD) 和非典型的变体,如PCA.
- 准确诊断EOAD亚型对于适当的管理和研究至关重要.
研究的目的:
- 使用18F-FDG PET. 识别PCA和早期发作的tAD中的表型特异性代谢模式.
- 评估这些代谢模式在区分PCA,早期发作的tAD和行为变异前性痴呆 (bv-FTD) 中的诊断价值.
- 评估这些模式与受影响个体的临床严重程度的相关性.
主要方法:
- 从患有PCA (n=40),早期发病tAD (n=37),bv-FTD (n=35) 和健康对照组 (HCs,n=30) 的患者获得了18F-FDG PET扫描.
- 参与者在发病时年龄小于65岁.
- 建立并验证了代谢模式,分析包括模式拓,表达,分类性能和与临床严重程度的相关性.
主要成果:
- 与PCA相关的模式 (PCARP) 显示在叶,叶和叶中具有广泛的低代谢,在虫和乳腺体中具有高代谢.
- 早期发病的tAD相关模式 (EOtADRP) 呈现了前额,顶额和部区域的低代谢,以及虫,乳头和后中心的高代谢.
- PCARP在区分PCA与早期发病tAD (AUC=0.84-0.88) 和区分这些与bv-FTD (AUC=1.00/0.91) 中表现出卓越的准确性,同时也与PCA和tAD的临床严重程度相关. 在PCA和tAD之间,EOtADRP的区分能力有限 (AUC=0.57-0.62).
结论:
- PCARP是一种有价值的神经成像生物标志物,用于区分PCA与早期发作的tAD.
- 在早期痴呆症中,PCARP在表型歧视和临床严重性评估方面显示出比EOtADRP更大的潜力.
- 18F-FDG PET衍生的代谢模式可以帮助准确诊断非典型的AD变体,如PCA.
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