Assessing the metabolism of the olfactory circuit by use of 18F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer's disease or frontotemporal dementia.

IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY
Daniël S L Loewenstein, Max van Grinsven, Cécile de Pont, Paul L J Dautzenberg, Astrid M van Strien, Dylan Henssen
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引用次数: 0

Abstract

Purpose: The loss of olfactory function is known to occur in patients suffering from (behavioral variant) frontotemporal dementia ((bv)FTD) and Alzheimer's disease (AD), although different pathophysiological mechanisms underpin this clinical symptom in both disorders. This study assessed whether brain metabolism of the olfactory circuit as assessed by positron emission tomography (PET) imaging with 2-[fluorine-18]fluoro-2-deoxy-d-glucose ([18F]-FDG) can distinguish these entities in different subsets of patients.

Methods: Patients presenting with cognitive decline were included from a prospectively kept database: (1) bvFTD patients, (2) AD patients and (3) patients with logopenic primary progressive aphasia (PPA). Metabolic rates were calculated for different regions of the olfactory circuit for each subgroup and compared with a cohort of subjects with normal brain metabolism. Additionally, in patients with a logopenic PPA pattern on PET-imaging, statistical parametric mapping (SPM) analysis was performed.

Results: The metabolism of subdivisions of the olfactory circuit as assessed by [18F]-FDG PET brain imaging to bvFTD and AD from control subjects resulted in sensitivity/specificity rates of 95/87.5% and 80/83.3%, respectively. A sensitivity/specificity rate of 100/87.5% was achieved when used to differentiate AD from bvFTD. In patients with the PPA pattern on imaging, the underlying cause (either FTD or AD) could be determined with a sensitivity/specificity rate of 88/82%. SPM analysis concurred that different regions of the olfactory circuit were affected in patients suffering from AD PPA or bvFTD PPA.

Conclusion: Metabolic dysfunction in the olfactory circuit is different in various neurodegenerative disorders. Further investigation of the correlations between the cerebral metabolism and the mechanisms which drive olfactory dysfunction is needed.

利用 18F-FDG PET-CT 成像评估阿尔茨海默氏症或额颞叶痴呆症疑似患者的嗅觉回路新陈代谢。
目的:众所周知,行为变异型额颞叶痴呆症((bv)FTD)和阿尔茨海默病(AD)患者会出现嗅觉功能丧失,但这两种疾病的临床症状是由不同的病理生理机制造成的。本研究通过使用 2-[氟-18]氟-2-脱氧-d-葡萄糖([18F]-FDG)的正电子发射断层扫描(PET)成像评估嗅觉回路的脑代谢,评估其是否能区分不同亚组患者的这些实体:从前瞻性数据库中选取了认知能力下降的患者:(1) bvFTD 患者;(2) AD 患者;(3) 对数开放性原发性进行性失语 (PPA) 患者。我们计算了每个亚组嗅觉回路不同区域的代谢率,并将其与大脑代谢正常的受试者进行了比较。此外,还对 PET 成像显示对数开放性 PPA 模式的患者进行了统计参数映射(SPM)分析:结果:通过[18F]-FDG PET脑成像评估嗅觉回路细分部位的新陈代谢,对照组与bvFTD和AD的敏感性/特异性分别为95/87.5%和80/83.3%。用于区分AD和bvFTD的灵敏度/特异性为100/87.5%。对于成像显示PPA模式的患者,可以确定潜在病因(FTD或AD),灵敏度/特异性分别为88%/82%。SPM分析表明,在患有AD PPA或bvFTD PPA的患者中,嗅觉回路的不同区域都受到了影响:结论:在各种神经退行性疾病中,嗅觉回路的代谢功能障碍各不相同。需要进一步研究大脑新陈代谢与驱动嗅觉功能障碍的机制之间的相关性。
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来源期刊
Alzheimer's Research & Therapy
Alzheimer's Research & Therapy 医学-神经病学
CiteScore
13.10
自引率
3.30%
发文量
172
审稿时长
>12 weeks
期刊介绍: Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.
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