Cerebral perfusion correlates of conversion to Alzheimer's disease in amnestic mild cognitive impairment

被引:76
作者
Caroli, Anna [1 ]
Testa, Cristina [1 ,2 ]
Geroldi, Cristina [1 ,3 ]
Nobili, Flavio [4 ]
Barnden, Leighton R. [5 ]
Guerra, Ugo P.
Bonetti, Matteo
Frisoni, Giovanni B. [1 ,3 ]
机构
[1] IRCCS San Giovanni Dio FBF, Lab Epidemiol Neuroimaging & Telemed, I-25125 Brescia, Italy
[2] Univ Udine, Dept Math & Comp Sci, Machine Vis Lab, I-33100 Udine, Italy
[3] IRCCS S Giovanni Dio FBF, Psychogeriatr Unit, Brescia, Italy
[4] Univ Genoa, Dept Endocrinol & Metab Sci, Div Clin Neurophysiol, I-16126 Genoa, Italy
[5] Queen Elizabeth Hosp, Dept Nucl Med, Adelaide, SA, Australia
关键词
mild cognitive impairment; conversion; SPECT; SPET;
D O I
10.1007/s00415-007-0631-7
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective Aim of this study was to find cerebral perfusion correlates of conversion to dementia in patients with amnestic MCI. Methods 17 healthy subjects (age = 69 +/- 3, 9 females), and 23 amnestic MCI patients (age = 70 +/- 6, 10 females) underwent brain MR scan and Tc-99m ECD SPECT. Conversion to AD was ascertained on average 19 +/- 10 months after baseline: 9 had converted (age = 69 +/- 3, 4 females), and 14 had not (age = 71 +/- 8, 6 females). We processed SPECT images with SPM2 following an optimized protocol and performed a voxel-based statistical analysis comparing amnestic MCI patients converted to AD and non-converted to dementia vs controls. We assessed the effect of gray matter atrophy on the above results with SPM2 using an optimized Voxel-Based Morphometry (VBM) protocol.We compared significant hypoperfusion with significant atrophy on a voxel-byvoxel basis. Results In comparison with normal controls, amnestic MCI patients who converted to AD showed hypoperfusion in the right parahippocampal gyrus and left inferior temporal and fusiform gyri,whereas those who did not convert showed hypoperfusion in the retrosplenial cortex, precuneus and occipital gyri, mainly on the left side.We found no overlap between significant atrophy and significant hypoperfusion regions. Conclusions Parahippocampal and inferior temporal hypoperfusion in amnestic MCI patients appears as a correlate of conversion to AD; hypoperfusion in the retrosplenial cortex is involved in memory impairment but does not seem the key prognostic indicator of conversion to dementia.
引用
收藏
页码:1698 / 1707
页数:10
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