인지기능 저하 노인에서 베타아밀로이드 양전자방출단층촬영의 효용성에 대한 증례군 보고 및 고찰
The Clinical Usefulness of Beta-Amyloid Positron Emission Tomography Imaging in the Elderly Patients : Case Series & Brief Review
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The aim was to evaluate the diagnostic utility of beta-amyloid positron emission tomography (PET) in elderly patients with cognitive impairment in the clinical setting. Five subjects underwent beta-amyloid PET imaging to explore the cerebral beta-amyloid deposition. The two male patients with minor neurocognitive disorder due to Alzheimer’s disease, who displayed similar degree of cognitive impairment and medial temporal atrophy but different in apolipoprotein E4 status, both showed negative for beta-amyloid PET. On the other hand, a female major neurocognitive disorder due to probable Alzheimer’s disease patient was tested positive for beta-amyloid PET, with increased beta-amyloid density in frontal and parietal lobes. Beta-amyloid PET was also used for the differential diagnosis of neurocognitive disorder from other psychiatric disorders in two elderly patients. The results were negative but assisted the diagnositic confirmation. A female patient was determined to be a case of late-onset schizophrenia and a male patient was determined as delirium due to minor traumatic brain injury, persistent. Beta-amyloid PET imaging was able to demonstrate cerebral beta-amyloid deposition in major neurocognitive disorder due to probable Alzheimer’s disease in visual scale. However, further studies are needed for its clinical utility in the minor neurocognitive disorders. Moreover, beta-amyloid PET imaging may provide additional information in diagnosing primary psychiatric disorders with new onset in the old age.
Abstract
The aim was to evaluate the diagnostic utility of beta-amyloid positron emission tomography (PET) in elderly patients with cognitive impairment in the clinical setting. Five subjects underwent beta-amyloid PET imaging to explore the cerebral beta-amyloid deposition. The two male patients with minor neurocognitive disorder due to Alzheimer’s disease, who displayed similar degree of cognitive impairment and medial temporal atrophy but different in apolipoprotein E4 status, both showed negative for beta-amyloid PET. On the other hand, a female major neurocognitive disorder due to probable Alzheimer’s disease patient was tested positive for beta-amyloid PET, with increased beta-amyloid density in frontal and parietal lobes. Beta-amyloid PET was also used for the differential diagnosis of neurocognitive disorder from other psychiatric disorders in two elderly patients. The results were negative but assisted the diagnositic confirmation. A female patient was determined to be a case of late-onset schizophrenia and a male patient was determined as delirium due to minor traumatic brain injury, persistent. Beta-amyloid PET imaging was able to demonstrate cerebral beta-amyloid deposition in major neurocognitive disorder due to probable Alzheimer’s disease in visual scale. However, further studies are needed for its clinical utility in the minor neurocognitive disorders. Moreover, beta-amyloid PET imaging may provide additional information in diagnosing primary psychiatric disorders with new onset in the old age.
참고문헌 (37)
- "2012 survey of dementia prevalence" (2012)[URL]
- Ott A, "Prevalence of Alzheimer’s disease and vascular dementia: association with education. The Rotterdam study", BMJ, 310, pp.970~973 (1995)
- Taipa R, "Clinico-pathological correlations of the most common neurodegenerative dementias", Front Neurol, 3, pp.68~ (2012)
- Hurt C, "Patient and caregiver perspectives of quality of life in dementia. An investigation of the relationship to behavioural and psychological symptoms in dementia", Dement Geriatr Cogn Disord, 26, pp.138~146 (2008)
- Berg L, "Mild senile dementia of the Alzheimer type: 2. Longitudinal assessment", Ann Neurol, 23, pp.477~484 (1988)
- Beeri MS, "The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer’s disease patients", Int J Geriatr Psychiatry, 17, pp.403~408 (2002)
- Hardy JA, "Alzheimer’s disease: the amyloid cascade hypothesis", Science, 256, pp.184~185 (1992)
- Braak H, "Neuropathological stageing of Alzheimer-related changes", Acta Neuropathol, 82, pp.239~259 (1991)
- Nordberg A, "PET imaging of amyloid in Alzheimer’s disease", Lancet Neurol, 3, pp.519~527 (2004)
- Doody RS, "Phase 3 trials of solanezumab for mild-to-moderate Alzheimer’s disease", N Engl J Med, 370, pp.311~321 (2014)
- Salloway S, "Two phase 3 trials of bapineuzumab in mild-to-moderate Alzheimer’s disease", N Engl J Med, 370, pp.322~333 (2014)
- Siemers ER, "Phase 3 solanezumab trials: secondary outcomes in mild Alzheimer’s disease patients", Alzheimers Dement, 12, pp.110~120 (2016)
- Jansen WJ, "Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis", JAMA, 313, pp.1924~1938 (2015)
- Clark CM, "Cerebral PET with florbetapir compared with neuropathology at autopsy for detection of neuritic amyloid-βplaques: a prospective cohort study", Lancet Neurol, 11, pp.669~678 (2012)
- PIB PET in a memory clinic cohort, "J Alzheimers Dis", 2014, 801~807
- Palmqvist S, "Accuracy of brain amyloid detection in clinical practice using cerebrospinal fluid β-amyloid 42: a cross-validation study against amyloid positron emission tomography", JAMA Neurol, 71, pp.1282~1289 (2014)
- Furukawa K, "Amyloid PET in mild cognitive impairment and Alzheimer’s disease with BF-227: comparison to FDG-PET", J Neurol, 257, pp.721~727 (2010)
- Pike KE, "Beta-amyloid imaging and memory in non-demented individuals: evidence for preclinical Alzheimer’s disease", Brain, 130, pp.2837~2844 (2007)
- Janoutová J, "Is mild cognitive impairment a precursor of Alzheimer's disease? Short review", Cent Eur J Public Health, 23, pp.365~367 (2015)
- PIB uptake is increased in mild cognitive impairment, "Neurology", 2007, 1603~1606
- "Medicine", 2014, e150~
- Scheltens P, "Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates", J Neurol Neurosurg Psychiatry, 55, pp.967~972 (1992)
- Schmechel DE, "Increased amyloid beta-peptide deposition in cerebral cortex as a consequence of apolipoprotein E genotype in late-onset Alzheimer disease", Proc Natl Acad Sci U S A, 90, pp.9649~9653 (1993)
- Ward A, "Prevalence of apolipoprotein E4 genotype and homozygotes (APOE e4", 4) among patients diagnosed with Alzheimer’s disease: a systematic review and meta-analysis, 2012, pp.38, 1~17
- Choi YH, "Distributions of ACE and APOE polymorphisms and their relations with dementia status in Korean centenarians", J Gerontol A Biol Sci Med Sci, 58, pp.227~231 (2003)
- Barthel H, "Cerebral amyloid-β PET with florbetaben (18F) in patients with Alzheimer’s disease and healthy controls: a multicentre phase 2 diagnostic study", Lancet Neurol, 10, pp.424~435 (2011)
- Saunders AM, "Specificity, sensitivity, and predictive value of apolipoprotein-E genotyping for sporadic Alzheimer’s disease", Lancet, 348, pp.90~93 (1996)
- Thai C, "Amyloid-related memory decline in preclinical Alzheimer’s disease is dependent on APOE ε4 and is detectable over 18-months", PLoS One, 10, pp.e0139082~ (2015)
- Koivunen J, "Amyloid PET imaging in patients with mild cognitive impairment: a 2-year follow-up study", Neurology, 76, pp.1085~1090 (2011)
- Castle DJ, "The epidemiology of late-onset schizophrenia", Schizophr Bull, 19, pp.691~700 (1993)
- Palmqvist S, "Detailed comparison of amyloid PET and CSF biomarkers for identifying early Alzheimer disease", Neurology, 85, pp.1240~1249 (2015)
- Hansson O, "Association between CSF biomarkers and incipient Alzheimer’s disease in patients with mild cognitive impairment: a follow-up study", Lancet Neurol, 5, pp.228~234 (2006)
- Buchhave P, "Cerebrospinal fluid levels of β-amyloid 1-42, but not of tau, are fully changed already 5 to 10 years before the onset of Alzheimer dementia", Arch Gen Psychiatry, 69, pp.98~106 (2012)
- Grimmer T, "Beta amyloid in Alzheimer’s disease: increased deposition in brain is reflected in reduced concentration in cerebrospinal fluid", Biol Psychiatry, 65, pp.927~934 (2009)
- Johnson KA, "Appropriate use criteria for amyloid PET: a report of the Amyloid Imaging Task Force, the Society of Nuclear Medicine and Molecular Imaging, and the Alzheimer’s Association", Alzheimers Dement, 9, pp.e1~e16 (2013)
- Leinonen V, "Assessment of beta-amyloid in a frontal cortical brain biopsy specimen and by positron emission tomography with carbon 11-labeled Pittsburgh Compound B", Arch Neurol, 65, pp.1304~1309 (2008)
- Woo JI, "The Korean version of the consortium to establish a registry for Alzheimer’s disease assessment packet" (2015), Seoul National University Press
