SPECT 영상을 이용한 경도인지장애 환자의 유형별 국소 뇌혈류 분석
Analysis of Regional Cerebral Blood Flow using Brain SPECT in the Patients with Mild Cognitive Impairment According to Subtypes
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: There are few studies in the analysis of regional cerebral blood flow (rCBF) using HMPAO SPECT in mild cognitive impairment (MCI) patients according to their subtypes. The aim of this study is to assess the specific patterns of rCBF in patients with MCI using Tc-99m HMPAO SPECT, and to compare the differences of rCBF among the subtypes of MCI. Methods: We recruited 192 MCI patients consecutively according to the Petersen’s clinical diagnostic criteria, who visited to the Dementia and Memory Clinic between January 1, 2005 and December 30, 2007. Ninety seven subjects who performed the brain MRI and Tc-99m HMPAO SPECT were included in this study. They were classified by three subtypes of MCI according to their deficits in cognitive domains; amnestic single domain MCI (aMCI-s, n=23), amnestic multi-domain MCI (aMCIm, n=58), non-amnestic MCI (naMCI, n=16). The rCBF were analysised by using statistical parameter mapping (SPM) analysis method. The SPECT data of all patients with MCI were compared with those of normal control and then the three groups of MCI were individually compared with those of control subjects. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the both parahippocampal gyrus, left insula and left sub-lobar in all MCI (uncorrected p<0.01). The patients with aMCI-s showed significant hypoperfusion on the left putamen and globus pallidus (uncorrected p<0.01). The patients with aMCI-m showed significant hypoperfusion areas on the left insula, left posterior cingulate gyrus, right parahippocampal gyrus and right cuneus (uncorrected p<0.01). The patients with naMCI revealed no significant hypoperfusion areas (uncorrected p<0.01). Conclusions: Our study shows characteristic and different pattern of perfusion deficits in patients with MCI. And, the pattern of perfusion deficits in amnestic multi-domain MCI are very similar to that of early stage of Alzheimer’s disease.
Abstract
Background: There are few studies in the analysis of regional cerebral blood flow (rCBF) using HMPAO SPECT in mild cognitive impairment (MCI) patients according to their subtypes. The aim of this study is to assess the specific patterns of rCBF in patients with MCI using Tc-99m HMPAO SPECT, and to compare the differences of rCBF among the subtypes of MCI. Methods: We recruited 192 MCI patients consecutively according to the Petersen’s clinical diagnostic criteria, who visited to the Dementia and Memory Clinic between January 1, 2005 and December 30, 2007. Ninety seven subjects who performed the brain MRI and Tc-99m HMPAO SPECT were included in this study. They were classified by three subtypes of MCI according to their deficits in cognitive domains; amnestic single domain MCI (aMCI-s, n=23), amnestic multi-domain MCI (aMCIm, n=58), non-amnestic MCI (naMCI, n=16). The rCBF were analysised by using statistical parameter mapping (SPM) analysis method. The SPECT data of all patients with MCI were compared with those of normal control and then the three groups of MCI were individually compared with those of control subjects. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the both parahippocampal gyrus, left insula and left sub-lobar in all MCI (uncorrected p<0.01). The patients with aMCI-s showed significant hypoperfusion on the left putamen and globus pallidus (uncorrected p<0.01). The patients with aMCI-m showed significant hypoperfusion areas on the left insula, left posterior cingulate gyrus, right parahippocampal gyrus and right cuneus (uncorrected p<0.01). The patients with naMCI revealed no significant hypoperfusion areas (uncorrected p<0.01). Conclusions: Our study shows characteristic and different pattern of perfusion deficits in patients with MCI. And, the pattern of perfusion deficits in amnestic multi-domain MCI are very similar to that of early stage of Alzheimer’s disease.
참고문헌 (25)
- Petersen RC, "Aging, memory, and mild cognitive impairment", Int Psychogeriatr, 9, pp.65~69 (1997)
- CSHA, "The incidence of dementia in Canada. The Canadian Study of Health and Aging Working Group", Neurology, 55, pp.66~73 (2000)
- Perterson RC, "Mild cognitive impairment as a diagnostic entity", Journal of Internal Medicine, 256, pp.183~194 (2004)
- Huang C, "Cingulatedcortex hypoperfuion predicts Alzheimer’s disease in mild cognitive impairment", BMC Neurology, 2, pp.9~ (2002)
- Busse A, "Riedel-Heller SG. Mild cognitive impairment Long-term course of four clinical subtypes", Neurology, 67, pp.2176~2185 (2006)
- Fischer P, "Conversion from subtypes of mild cognitive impairment to Alzheimer dementia", Neurology, 68, pp.288~291 (2007)
- Erten-Lyons D, "Brain volume loss in MCI predicts dementia", Neurology, 66, pp.233~235 (2006)
- Matsuda H, "Symposium: brain imaging and neropathology, The role of neuroimaging in mild cognitive impairment", Neuropathology, 27, pp.570~577 (2007)
- Caffarra P, "Differential patterns of hypoperfuion in subtypes of mild cognitive impairment", Open Neuroimag J, 2, pp.20~28 (2008)
- Nobili F, "Brain SPECT in subtypes of mild cognitive impairment", J Neurol, 255, pp.1344~1353 (2008)
- Johnson NA, "Pattern of cerebral hypoperfusion in Alzheimer disease and mild cognitive impairment measured with arterial spin-labeling MR imaging: initial experience", Radiology, 234, pp.851~859 (2005)
- Drzezga A, "Cerebral metabolic changes accompanying conversion of mild cognitive impairment into Alzheimer’s disease: a PET follow-up study", Eur J Nucl Med Mol Imaging, 30, pp.1104~1113 (2003)
- Chang LT, "A method for attenuation correction in radionuclide computed tomograpgy", pp.638~643 (1978), IEEE Trans Nucl Sci
- Friston KJ, "Statistical parametric maps in functional imaging: a general linear approach", Hum Brain Mapp, 2, pp.189~210 (1994)
- Lancaster JL, "Automated talairach atlas labels for functional brain mapping", Hum Brain Mapp, 10, pp.120~131 (2000)
- Hirao K, "The prediction of rapid conversion to Alzheimer’s disease in mild cognitive impairment using regional cerebral blood flow SPECT", NeuroImage, 28, pp.1014~1021 (2005)
- Chetelat G, "Mappinf gray matter loss with voxel-based morphometry in mild cognitive impairment", Neuroreport, 13, pp.1939~1943 (2002)
- Encinas M, "Regional cerebral blood flow assessed with 99mTc-ECD SPECT as a marker of pregression of mild cognitive impairment to Alzheimer’s disease", Eur J Nucl Med Mol Imaging, 30, pp.1473~1480 (2003)
- Chatelat G, "FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment", Neurocase, 11, pp.14~25 (2005)
- Ishiwata A, "Preclinical evidence of Alzheimer changes in progressive mild cognitive impairment: a qualitative and quantitative SPECT study", Acta Neurol Scand, 114, pp.91~96 (2006)
- Drzezga A, "Prediction of Individual Clinical Outcome in MCI by Means of Genetic Assessment and 18F-FDG PET", J Nucl Med, 46, pp.1625~1632 (2005)
- Mosconi L, "Convit A, et al. Reduced hippocampal metabolism in MCI and AD", Neurology, 64, pp.1860~1867 (2005)
- Johnson KA, "Single photon emission computed tomography perfusion differences in mild cognitive impairment", J Neurol Neurosug Psychiatry, 78, pp.240~247 (2007)
- Caroli A, "Cerebral perfuion correlates of conversion to Alzheimer’s disease in amnestic mild cognitive impairment", J Neurol, 254, pp.1698~1707 (2007)
- 양동원, "기억성 경도인지장애와 초기 알쯔하이머병에서의 국소뇌혈류 변화", Dementia and Neurocognitive Disorders(대한치매학회지), 6(2), pp.29~33 (2007), 대한치매학회