Prediction of cognitive decline in normal elderly subjects with 2-[ <sup>18</sup> F]fluoro-2-deoxy- <scp>d</scp> -glucose/positron-emission tomography (FDG/PET)

Proceedings of the National Academy of Sciences of the United States of America - Tập 98 Số 19 - Trang 10966-10971 - 2001
Mony J. de Leon1, Antonio Convit2,3, Oliver T. Wolf4,3, Chaim Tarshish3, Susan DeSanti3, Henry Rusinek3, Wai Tsui3, Emad Kandil3, Adam Scherer3, Alexandra Roche3, A. Imossi3, Emma Woodoff‐Leith3, Matthew Bobinski3, Conrad Caraos3, P Lesbre3, David J. Schlyer5, John T. Poirier6, ‌Barry Reisberg3, Joanna S. Fowler5
1Center for Brain Health, New York University School of Medicine, New York, NY 10016, USA
2Nathan S. Kline Institute for Psychiatric Research
3New York University
4Heinrich Heine University Düsseldorf
5Brookhaven National Laboratory
6McGill University

Tóm tắt

Neuropathology studies show that patients with mild cognitive impairment (MCI) and Alzheimer's disease typically have lesions of the entorhinal cortex (EC), hippocampus (Hip), and temporal neocortex. Related observations with in vivo imaging have enabled the prediction of dementia from MCI. Although individuals with normal cognition may have focal EC lesions, this anatomy has not been studied as a predictor of cognitive decline and brain change. The objective of this MRI-guided 2-[ 18 F]fluoro-2-deoxy- d -glucose/positron-emission tomography (FDG/PET) study was to examine the hypothesis that among normal elderly subjects, EC METglu reductions predict decline and the involvement of the Hip and neocortex. In a 3-year longitudinal study of 48 healthy normal elderly, 12 individuals (mean age 72) demonstrated cognitive decline (11 to MCI and 1 to Alzheimer's disease). Nondeclining controls were matched on apolipoprotein E genotype, age, education, and gender. At baseline, metabolic reductions in the EC accurately predicted the conversion from normal to MCI. Among those who declined, the baseline EC predicted longitudinal memory and temporal neocortex metabolic reductions. At follow-up, those who declined showed memory impairment and hypometabolism in temporal lobe neocortex and Hip. Among those subjects who declined, apolipoprotein E E4 carriers showed marked longitudinal temporal neocortex reductions. In summary, these data suggest that an EC stage of brain involvement can be detected in normal elderly that predicts future cognitive and brain metabolism reductions. Progressive E4-related hypometabolism may underlie the known increased susceptibility for dementia. Further study is required to estimate individual risks and to determine the physiologic basis for METglu changes detected while cognition is normal.

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Proceedings of the National Academy of Sciences of the United States of America

Tập 98 Số 19

10966-10971

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