Abstract
BACKGROUND AND PURPOSE: Decreased glucose metabolism in the temporal and parietal lobes on FDG-PET is recognized as an early imaging marker for the AD pathology. Our objective was to investigate the effects of age on FDG-PET findings in aMCI.
MATERIALS AND METHODS: Twenty-five patients with aMCI at 55–86 years of age (median = 73 years) and 25 age- and sex-matched CN subjects underwent FDG-PET. SPM5 was used to compare the FDG uptake in patients in aMCI-old (>73 years) and aMCI-young (≤73 years) groups with CN subjects. The findings in the aMCI-old patients were independently validated in a separate cohort of 10 aMCI and 13 CN subjects older than 73 years of age.
RESULTS: The pattern of decreased glucose metabolism and gray matter atrophy in the medial temporal, posterior cingulate, precuneus, lateral parietal, and temporal lobes in aMCI-young subjects was consistent with the typical pattern observed in AD. The pattern of glucose metabolic changes in aMCI-old subjects was different, predominantly involving the frontal lobes and the left parietal lobe. Gray matter atrophy in aMCI-old subjects was less pronounced than that in the aMCI-young subjects, involving the hippocampus and the basal forebrain in both hemispheres
CONCLUSIONS: Pathologic heterogeneity may be underlying the absence of AD-like glucose metabolic changes in older compared with younger patients with aMCI. This may be an important consideration for the clinical use of temporoparietal hypometabolism on FDG-PET as a marker for early diagnosis of AD in aMCI.
Abbreviations
- AAL
- automated anatomic labeling
- AD
- Alzheimer disease
- ADRC/ADPR
- Alzheimer's Disease Research Center/Alzheimer's Disease Patient Registry
- aMCI
- amnestic mild cognitive impairment
- CDR
- Clinical Dementia Rating
- CN
- cognitively normal
- DCT
- discrete cosine transformation
- FDG-PET
- fluorodeoxyglucose–positron-emission tomography
- FLAIR
- fluid-attenuated inversion recovery
- IQR
- interquartile range
- MCI
- mild cognitive impairment
- MMSE
- Mini-Mental State Examination
- SPM
- statistical parametric mapping
- VBM
- voxel-based morphometry
- WMH
- white matter hyperintensities
- Copyright © American Society of Neuroradiology
Indicates open access to non-subscribers at www.ajnr.org