A study of the clinical features of PIB-negative dementia patients in amyloid PET

PIB阴性痴呆患者淀粉样蛋白PET临床特征研究

基本信息

批准号：
21613007
负责人：
SHIMADA Hiroyuki
金额：
$ 2.83万
依托单位：
Osaka City University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2011
项目状态：
已结题

项目摘要

Background/Aims : We previously found that some cases of clinically diagnosed Alzheimer's disease(AD) were rated as Pittsburgh compound-B(PiB)-negative by amyloid imaging(ie, cases of PiB-negative dementia). These may involve diseases that do not have pathological amyloid accumulation in the brain, such as dementia with Lewy bodies(DLB), frontotemporal lobar degeneration(FTLD), argyrophilic grain disease(AGD), and neurofibrillary tangle-predominant dementia(NFTD), as well as AD itself. The present study was designed to analyze the clinical features of PiB-negative dementia patients in detail with cerebrospinal fluid(CSF) analysis and neuroradiological tests. Methods : Of the 64 cases of clinically diagnosed AD, 14 were rated PiB-negative with PiB-positron emission tomography(PET). Eleven of these were further analyzed using CSF biomarker levels and findings from magnetic resonance imaging(MRI), fluorodeoxyglucose(FDG)-PET,<123>^I-metaiodobenzylguanidine(MIBG) myocardial scintigraphy, and voxel-based morphometry(VBM). Results : When examined by<123>^I-MIBG myocardial scintigraphy, the PiB-negative dementia group differed slightly from the healthy control group in both the early and delayed phases, and the H/M ratio was significantly higher in the PiB-negative dementia group than in the DLB group. Analyses of CSF biomarkers and MRI and FDG-PET findings among the 11 cases of PiB-negative dementia suggested AGD in 3 cases, FTLD in 3 cases, NFTD in 1 case, and AD in 2 cases. Conclusion : PiB-negative dementia is unlikely to include DLB, while it most likely includes diseases of tauopathy, such as FTLD, AGD, and NFTD. A better understanding of PiB-negative dementia is expected to further improve the accuracy of clinical diagnosis of AD.

背景/目的：我们以前发现，某些临床诊断的阿尔茨海默氏病（AD）被评为匹兹堡化合物-B（PIB）通过淀粉样蛋白成像（即，PIB阴性痴呆症病例）。这些可能涉及在大脑中没有病理淀粉样蛋白积累的疾病，例如与Lewy身体（DLB）的痴呆症（DLB），额颞Lobar变性（FTLD），Argyrophilic Grairic Grain疾病（AGD）和Neurofirillary Tangle Tangle tankle-Predominant-Presdominantiantia（NFTD），以及以及广告本身。本研究旨在通过脑脊液（CSF）分析详细分析PIB阴性痴呆患者的临床特征和神经放射学检查。方法：在64例临床诊断的AD病例中，有14例用PIB-Positron发射断层扫描（PET）评为PIB阴性。使用CSF生物标志物水平和磁共振成像（MRI），氟脱氧葡萄糖（FDG）-PET，<123>^i-metaiodobenzylguanidine（mibg）心肌刺激物和基于voxel的Meterphementry（VBMM）。结果：当通过<123>^i-mibg心肌闪烁显像检查时，PIB阴性痴呆症组在早期和延迟阶段中与健康对照组略有不同，而PIB阴性的H/M比显着较高痴呆组比在DLB组中。在11例PIB阴性痴呆症病例中，对CSF生物标志物以及MRI和FDG-PET发现的分析表明3例AGD，3例FTLD，在3例中，NFTD为1例，在2例中进行了AD。结论：PIB阴性痴呆不太可能包括DLB，而它很可能包括FTLD，AGD和NFTD等tauopathy疾病。对PIB阴性痴呆的更好理解有望进一步提高AD临床诊断的准确性。