Objectives: To investigate whether the combination of fluoro-2-deoxy-D-glu cose (FDG) PET measures with the APOE genotype would improve prediction of the c onversion frommild cognitive impairment (MCI) to Alzheimer di...Objectives: To investigate whether the combination of fluoro-2-deoxy-D-glu cose (FDG) PET measures with the APOE genotype would improve prediction of the c onversion frommild cognitive impairment (MCI) to Alzheimer disease (AD).Method: After 1 year, 8 of 37 patients with MCI converted to AD (22%). Differences in b aseline regional glucose metabolicrate (rCMRglc) across groups were assessed on a voxel-based basis using a two-factor analysis of variance with outcome (conv erters[n = 8] vs nonconverters [n = 29]) and APOE genotype (E4 carriers [E4+] [ n = 16] vs noncarriers [E4-] [n = 21]) asgrouping factors. Results were conside red significant at p < 0.05, corrected for multiple comparisons. Results: All co nverters showed reduced rCMRglc in the inferior parietal cortex(IPC) as compared with the nonconverters. Hypometabolismin AD-typical regions, that is, temporop arietal and posteriorcingulate cortex, was found for the E4+as compared with th e E4-patients, with the E4+/converters (n = 5) having additional rCMRglc reduc tions within frontal areas, such as the anterior cingulate (ACC) and inferior fr ontal (IFC) cortex. For the whole MCI sample, IPC rCMRglc predicted conversion t o AD with 84%overall diagnostic accuracy (p = 0.003). Moreover,ACC and IFC rCMR glc improved prediction for the E4+group,yielding 100%sensitivity, 90%specifi city, and 94%accuracy (p < 0.0005), thus leading to an excellent discrimination . Conclusion:Fluoro-2-deoxy-D-glucose-PET measures may improve prediction o f the conversion to Alzheimer disease, especially in combination with the APOE g enotype.展开更多
文摘Objectives: To investigate whether the combination of fluoro-2-deoxy-D-glu cose (FDG) PET measures with the APOE genotype would improve prediction of the c onversion frommild cognitive impairment (MCI) to Alzheimer disease (AD).Method: After 1 year, 8 of 37 patients with MCI converted to AD (22%). Differences in b aseline regional glucose metabolicrate (rCMRglc) across groups were assessed on a voxel-based basis using a two-factor analysis of variance with outcome (conv erters[n = 8] vs nonconverters [n = 29]) and APOE genotype (E4 carriers [E4+] [ n = 16] vs noncarriers [E4-] [n = 21]) asgrouping factors. Results were conside red significant at p < 0.05, corrected for multiple comparisons. Results: All co nverters showed reduced rCMRglc in the inferior parietal cortex(IPC) as compared with the nonconverters. Hypometabolismin AD-typical regions, that is, temporop arietal and posteriorcingulate cortex, was found for the E4+as compared with th e E4-patients, with the E4+/converters (n = 5) having additional rCMRglc reduc tions within frontal areas, such as the anterior cingulate (ACC) and inferior fr ontal (IFC) cortex. For the whole MCI sample, IPC rCMRglc predicted conversion t o AD with 84%overall diagnostic accuracy (p = 0.003). Moreover,ACC and IFC rCMR glc improved prediction for the E4+group,yielding 100%sensitivity, 90%specifi city, and 94%accuracy (p < 0.0005), thus leading to an excellent discrimination . Conclusion:Fluoro-2-deoxy-D-glucose-PET measures may improve prediction o f the conversion to Alzheimer disease, especially in combination with the APOE g enotype.
