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
Platelet Amyloid Precursor Protein ratio of different abnormal forms and 99mTc-ECD SPECT perfusion analysis were evaluated in Mild Cognitive Impairment (MCI) subjects who progressed to Alzheimer Disease (AD) and in st...Platelet Amyloid Precursor Protein ratio of different abnormal forms and 99mTc-ECD SPECT perfusion analysis were evaluated in Mild Cognitive Impairment (MCI) subjects who progressed to Alzheimer Disease (AD) and in stable MCI. We report that their combined evaluation increases the discriminative power of the analysis in identifying presymptomatic AD. The positive predictive value of these combined markers in identifying progressive MCI was 0.87, and the negative predictive value was 0.90. This observation suggests that the interplay of different markers should be considered for enhancing diagnostic accuracy of pre-clinical AD.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.
文摘Platelet Amyloid Precursor Protein ratio of different abnormal forms and 99mTc-ECD SPECT perfusion analysis were evaluated in Mild Cognitive Impairment (MCI) subjects who progressed to Alzheimer Disease (AD) and in stable MCI. We report that their combined evaluation increases the discriminative power of the analysis in identifying presymptomatic AD. The positive predictive value of these combined markers in identifying progressive MCI was 0.87, and the negative predictive value was 0.90. This observation suggests that the interplay of different markers should be considered for enhancing diagnostic accuracy of pre-clinical AD.
