Jiaqi Niu, Yan Zhong, Le Xue, Haotian Wang, Daoyan Hu, Yi Liao, Xiaohui Zhang, Xiaofeng Dou, Congcong Yu, Bo Wang, Yuan Sun, Mei Tian, Hong Zhang, Jing Wang
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Our study aimed to use disease progression modeling to uncover spatial-temporal dynamic evolution of LBD in vivo, and to explore differential profiles of clinical features, glucose metabolism, and dopaminergic function among different evolution-related subtypes.</p><p><strong>Methods: </strong>A total of 123 participants (31 healthy controls and 92 LBD patients) who underwent <sup>18</sup>F-FDG PET scans were retrospectively enrolled. <sup>18</sup>F-FDG PET-based Subtype and Stage Inference (SuStaIn) model was established to illustrate spatial-temporal evolutionary patterns and categorize relevant subtypes. Then subtypes and stages were further related to clinical features, glucose metabolism, and dopaminergic function of LBD patients.</p><p><strong>Results: </strong>This <sup>18</sup>F-FDG PET imaging-based approach illustrated two distinct patterns of neurodegenerative evolution originating from the neocortex and basal ganglia in LBD and defined them as subtype 1 and subtype 2, respectively. There were obvious differences between subtypes. Compared with subtype 1, subtype 2 exhibited a greater proportion of male patients (P = 0.045) and positive symptoms such as visual hallucinations (P = 0.033) and fluctuating cognitions (P = 0.033). Cognitive impairment, metabolic abnormalities, dopaminergic dysfunction and progression were all more severe in subtype 2 (all P < 0.05). 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引用次数: 0
摘要
目的：路易体痴呆（LBD）是一种具有高度异质性和复杂发病机制的神经退行性疾病。我们的研究旨在利用疾病进展模型揭示体内路易体痴呆的时空动态演变，并探索不同演变相关亚型的临床特征、糖代谢和多巴胺能功能的差异特征：方法：回顾性纳入了123名接受18F-FDG PET扫描的参与者（31名健康对照组和92名枸杞多糖症患者）。建立了基于 18F-FDG PET 的亚型和分期推断（SuStaIn）模型，以说明时空演变模式并对相关亚型进行分类。然后进一步将亚型和分期与枸杞多糖症患者的临床特征、糖代谢和多巴胺能功能相关联：结果：这种基于 18F-FDG PET 成像的方法揭示了 LBD 神经退行性演变的两种不同模式，分别源自新皮质和基底节，并将它们定义为亚型 1 和亚型 2。亚型之间存在明显差异。与亚型 1 相比，亚型 2 的男性患者比例更高（P = 0.045），并表现出视幻觉（P = 0.033）和认知波动（P = 0.033）等阳性症状。认知障碍、代谢异常、多巴胺能功能障碍和病情进展均在亚型 2 中更为严重（均为 P 结论：亚型 2 患者的认知障碍、代谢异常、多巴胺能功能障碍和病情进展均在亚型 2 中更为严重（均为 P我们基于 18F-FDG PET 和数据驱动模型的研究结果说明了枸杞多糖症的时空动态演化，并在体内将具有不同演化模式、临床和影像学特征的新型亚型进行了分类。与演变相关的亚型与枸杞多糖临床表型相关，这支持了枸杞多糖谱中存在不同实体的观点。
Spatial-temporal dynamic evolution of lewy body dementia by metabolic PET imaging.
Purpose: Lewy body dementia (LBD) is a neurodegenerative disease with high heterogeneity and complex pathogenesis. Our study aimed to use disease progression modeling to uncover spatial-temporal dynamic evolution of LBD in vivo, and to explore differential profiles of clinical features, glucose metabolism, and dopaminergic function among different evolution-related subtypes.
Methods: A total of 123 participants (31 healthy controls and 92 LBD patients) who underwent 18F-FDG PET scans were retrospectively enrolled. 18F-FDG PET-based Subtype and Stage Inference (SuStaIn) model was established to illustrate spatial-temporal evolutionary patterns and categorize relevant subtypes. Then subtypes and stages were further related to clinical features, glucose metabolism, and dopaminergic function of LBD patients.
Results: This 18F-FDG PET imaging-based approach illustrated two distinct patterns of neurodegenerative evolution originating from the neocortex and basal ganglia in LBD and defined them as subtype 1 and subtype 2, respectively. There were obvious differences between subtypes. Compared with subtype 1, subtype 2 exhibited a greater proportion of male patients (P = 0.045) and positive symptoms such as visual hallucinations (P = 0.033) and fluctuating cognitions (P = 0.033). Cognitive impairment, metabolic abnormalities, dopaminergic dysfunction and progression were all more severe in subtype 2 (all P < 0.05). In addition, a strong association was observed between SuStaIn subtypes and two clinical phenotypes (Parkinson's disease dementia and dementia with Lewy bodies) (P = 0.005).
Conclusions: Our findings based on 18F-FDG PET and data-driven model illustrated spatial-temporal dynamic evolution of LBD and categorized novel subtypes with different evolutionary patterns, clinical and imaging features in vivo. The evolution-related subtypes are associated with LBD clinical phenotypes, which supports the perspective of existence of distinct entities in LBD spectrum.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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