行为变异型额颞叶痴呆患者脑葡萄糖代谢特征研究  

Characteristics of Cerebral Glucose Metabolism in Patients with Behavioural Variant Frontotemporal Dementia

作　　者：朱毓华 陈怡静 葛璟洁 吴平 王坚 刘丰韬 张政伟 管一晖 左传涛 ZHU Yu-hua;CHEN Yi-jing;GE Jing-jie;WU-Ping;WANG Jian;LIU Feng-tao;ZHANG Zheng-wei;GUAN Yi-hui;ZUO Chuan-tao(PET Center,Huashan Hospital,Fudan University,Shanghai 200235,China;Department of Neurology,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院PET中心,上海200235 [2]复旦大学附属华山医院神经内科,上海200040

出　　处：《中国临床神经科学》2020年第3期259-265,共7页Chinese Journal of Clinical Neurosciences

基　　金：国家自然科学基金课题(编号:81971641,81902282);上海市科委扬帆计划课题(编号:18YF1403100)。

摘　　要：目的利用^18F-FDG正电子发射断层扫描(PET)成像分析行为变异型额颞叶痴呆(bvFTD)患者脑葡萄糖代谢特征以及在阿尔茨海默病(AD)鉴别诊断中的应用价值。方法纳入临床确诊的bvFTD患者(bvFTD组,14例)、健康对照者(对照组,14例)和AD患者(AD组,14例),先将bvFTD和对照组的PET图像分别进行统计参数图(SPM)及尺度子轮廓模型/主要成分分析(SSM/PCA)分析,获得bvFTD患者脑部葡萄糖代谢图谱并建立bvFTD相关脑代谢网络模式(bvFTDRP);计算bvFTD组、对照组和AD组的bvFTDRP个体表达值,并进行ROC分析。结果SPM和SSM/PCA分析均显示bvFTD组表现出双侧前额叶和基底节区葡萄糖代谢显著减低。bvFTDRP表达值在3组间差异均有显著统计学意义(ANOVA:F[2,39]=86.663,P<0.001),且可有效鉴别bvFTD和AD患者。结论bvFTD存在与疾病特异相关的脑葡萄糖代谢特征,为^18F-FDG PET应用于痴呆诊断提供了客观依据。Aim To identify abnormal cerebral glucose metabolism characteristics in patients with behavioral variant frontotemporal dementia(bvFTD)with ^18F-FDG PET imaging and to evaluate its value in discrimination with Alzheimer’s disease(AD).Methods The PET imaging of 14 bvFTD,14 healthy controls(HC)and 14 AD patients were analyzed using SPM and SSM/PCA respectively.Distribution of brain glucose metabolism in bvFTD patients was obtained and bvFTD-related pattern(bvFTDRP)was established.The expression of bvFTDRP in bvFTD,HC and AD individuals were calculated and ROC analysis was conducted.Results SPM and SSM/PCA analysis both showed that patients with bvFTD showed significant reduction of glucose metabolism in the bilateral prefrontal and basal ganglia areas.There was significant difference in bvFTDRP scores across bvFTD,HC and AD groups(ANOVA:F[2,39]=86.663,P<0.001),and the expression could effectively distinguish between bvFTD and AD patients.Conclusion:bv FTD patients exhibit cerebral glucose metabolism features that are specifically related to the disease,and may provide objective clues for the application of ^18F-FDG PET imaging in diagnosis of dementia.

关 键 词：行为变异型 额颞叶痴呆 脑代谢网络模式 ^18氟-脱氧葡萄糖 正电子发射断层扫描成像 阿尔茨海默病 

分 类 号：R445.5[医药卫生—影像医学与核医学]