目的:一半的ALS患者存在认知和/或行为障碍。由于认知/行为和脑葡萄糖代谢可以通过18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)相关联,我们的目标是利用FDG-PET,首先,为了复制非痴呆性ALS患者之间葡萄糖代谢的组间水平差异,认知障碍(ALSci),行为受损(ALSBI),以及认知和行为受损(ALScbi)群体;第二,研究不同认知领域的葡萄糖代谢和表现;第三,检查FDG-PET数据的部分体积效应校正(PVEC)对结果的影响。
方法:我们分析了神经心理学,临床,和67例ALS患者的影像学数据(30例ALSni,21ALSci,5ALSbi,和11ALScbi)。使用爱丁堡认知和行为ALS屏幕评估认知,和两项社会认知测试.对每位患者进行FDG-PET和结构MRI扫描。基于体素的统计分析对灰质体积(GMV)和未校正的与PVE校正的FDG-PET扫描。
结果:ALSci和ALScbi的认知评分低于ALSni。与ALSni和ALSci相比,ALScbi除了右颞极外,还在上叶和中额叶回表现出广泛的低代谢。观察到GMV之间的相关性,FDG-PET信号,和各种认知得分。FDG-PET结果在很大程度上不受PVEC的影响。
结论:我们的研究发现,ALSci-ni组比较中存在广泛的低代谢差异,提高脑代谢可能与行为改变的存在比轻度认知缺陷更密切相关的可能性。
OBJECTIVE: Half of ALS patients are cognitively and/or behaviourally impaired. As cognition/behaviour and cerebral glucose metabolism can be correlated by means of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET), we aimed to utilise FDG-PET, first, to replicate group-level differences in glucose metabolism between non-demented ALS patients separated into non-impaired (ALSni), cognitively impaired (ALSci), behaviourally impaired (ALSbi), and cognitively and behaviourally impaired (ALScbi) groups; second, to investigate glucose metabolism and performance in various cognitive domains; and third, to examine the impact of partial volume effects correction (PVEC) of the FDG-PET data on the results.
METHODS: We analysed neuropsychological, clinical, and imaging data from 67 ALS patients (30 ALSni, 21 ALSci, 5 ALSbi, and 11 ALScbi). Cognition was assessed with the Edinburgh Cognitive and Behavioural ALS Screen, and two social cognition tests. FDG-PET and structural MRI scans were acquired for each patient. Voxel-based statistical analyses were undertaken on grey matter volume (GMV) and non-corrected vs. PVE-corrected FDG-PET scans.
RESULTS: ALSci and ALScbi had lower cognitive scores than ALSni. In contrast to both ALSni and ALSci, ALScbi showed widespread hypometabolism in the superior- and middle-frontal gyri in addition to the right temporal pole. Correlations were observed between the GMV, the FDG-PET signal, and various cognitive scores. The FDG-PET results were largely unaffected by PVEC.
CONCLUSIONS: Our study identified widespread differences in hypometabolism in the ALScbi-ni but not in the ALSci-ni group comparison, raising the possibility that cerebral metabolism may be more closely related to the presence of behavioural changes than to mild cognitive deficits.