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Brain Metabolism of Less-Educated Patients With Alzheimer Dementia Studied by Positron Emission Tomography.

Huang YC, Yen PS, Wu ST, Chen JT, Hung GU, Kao CH, Chen TY, Ho FM - Medicine (Baltimore) (2015)

Bottom Line: Nevertheless, mild DAT in illiterate participants seems to be due to brain atrophy.In this study, we compared the impact of brain metabolism efficiency in healthy participants and less-educated patients with mild DAT using 2-fluoro-2-deoxy-D-glucose (F-FDG-PET) positron emission tomography.Participants with intracranial insults were excluded by brain magnetic resonance imaging and participants with metabolic or systemic conditions were excluded by blood sampling.The PET imaging data were analyzed using statistical parametric mapping (SPM8) to determine reliability and specificity.Glucose metabolic rate was low in the DAT group, especially in the middle temporal gyrus, middle frontal gyrus, superior frontal gyrus, inferior frontal gyrus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, middle occipital gyrus, rectal gyrus, and lingual gyrus.Our results showed that DAT patients with less education not only have prominent clinical signs and symptoms related to dementia but also decreased gray matter metabolism.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neurology (YCH), Chang Bing Show Chwan Memorial Hospital; Department of Bioindustry Technology (YCH, STW), Dayeh University, Chang Hua; Department of Neurology (YCH), Taoyuan General Hospital, Ministry of Health and Welfare, Executive Yuan; Asian Institute of TeleSurgery (AITS) (JTC), Show Chwan Healthcare System; Department of Nuclear Medicine (GUH), Chang Bing Show Chwan Memorial Hospital; Department of Nuclear Medicine and PET Center (CHK), China Medical University Hospital; Graduate Institute of Clinical Medical Science and School of Medicine (CHK), College of Medicine, China Medical University, Taichung; Department of Radiology (TYC), Chang Bing Show Chwan Memorial Hospital; and Department of Internal Medicine (PSY, FMH), Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.

ABSTRACT
Alzheimer dementia (AD) is the commonest form of dementia. Although illiteracy is associated with high prevalence of dementia of the Alzheimer type (DAT), their relationship is still unclear. Nevertheless, mild DAT in illiterate participants seems to be due to brain atrophy.In this study, we compared the impact of brain metabolism efficiency in healthy participants and less-educated patients with mild DAT using 2-fluoro-2-deoxy-D-glucose (F-FDG-PET) positron emission tomography. Out of 43 eligible less-educated participants with dementia, only 23 (14 women and 9 men) met Diagnostic and Statistical Manual (DSM)-III-R or DSM-IV criteria for DAT and AD and were included. Participants with intracranial insults were excluded by brain magnetic resonance imaging and participants with metabolic or systemic conditions were excluded by blood sampling. In addition, 16 cognitively normal elderly (age >70 years), including 7 women and 9 men, were enrolled in the sham group. The PET imaging data were analyzed using statistical parametric mapping (SPM8) to determine reliability and specificity.Glucose metabolic rate was low in the DAT group, especially in the middle temporal gyrus, middle frontal gyrus, superior frontal gyrus, inferior frontal gyrus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, middle occipital gyrus, rectal gyrus, and lingual gyrus.Our results showed that DAT patients with less education not only have prominent clinical signs and symptoms related to dementia but also decreased gray matter metabolism.

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The design matrix. Groups 1 and 2 are Alzheimer dementia and normal control participants, respectively. The right 3 columns represent the covariance vector of age, minimental statement examination score, and years of education, respectively. The signal intensity of each entry in the matrix represents the magnitude of the covariance.
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Figure 1: The design matrix. Groups 1 and 2 are Alzheimer dementia and normal control participants, respectively. The right 3 columns represent the covariance vector of age, minimental statement examination score, and years of education, respectively. The signal intensity of each entry in the matrix represents the magnitude of the covariance.

Mentions: There were 23 participants (14 women, 9 men; mean age ± standard deviation [SD], 75.39 ± 8.42 years [range 52–90]; mean MMSE score 15.78 ± 6.03; Table 1) in the dementia group and only 16 participants (7 women, 9 men; age mean age ± SD, 75.06 ± 4.73 years [range 70–87]) in the normal control group. The study population is shown with the design matrix in Figure 1. In Figure 2, the darker areas indicate lower rates of glucose metabolism.15 Areas are significantly brighter in group 1 than group 2, indicating the brain is more active in educated participants (group 1). The gray shades in different areas represent atrophy, and the level of gray intensity indicates the degree of atrophy. Our analysis shows a significantly lower glucose metabolic rate in the following brain areas of the less-educated dementia group: middle temporal gyrus, middle frontal gyrus, superior frontal gyrus, inferior frontal gyrus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, middle occipital gyrus, rectal gyrus, and lingual gyrus (Table 2). For clarification, the data in Figure 2 are summarized in Table 2.


Brain Metabolism of Less-Educated Patients With Alzheimer Dementia Studied by Positron Emission Tomography.

Huang YC, Yen PS, Wu ST, Chen JT, Hung GU, Kao CH, Chen TY, Ho FM - Medicine (Baltimore) (2015)

The design matrix. Groups 1 and 2 are Alzheimer dementia and normal control participants, respectively. The right 3 columns represent the covariance vector of age, minimental statement examination score, and years of education, respectively. The signal intensity of each entry in the matrix represents the magnitude of the covariance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554129&req=5

Figure 1: The design matrix. Groups 1 and 2 are Alzheimer dementia and normal control participants, respectively. The right 3 columns represent the covariance vector of age, minimental statement examination score, and years of education, respectively. The signal intensity of each entry in the matrix represents the magnitude of the covariance.
Mentions: There were 23 participants (14 women, 9 men; mean age ± standard deviation [SD], 75.39 ± 8.42 years [range 52–90]; mean MMSE score 15.78 ± 6.03; Table 1) in the dementia group and only 16 participants (7 women, 9 men; age mean age ± SD, 75.06 ± 4.73 years [range 70–87]) in the normal control group. The study population is shown with the design matrix in Figure 1. In Figure 2, the darker areas indicate lower rates of glucose metabolism.15 Areas are significantly brighter in group 1 than group 2, indicating the brain is more active in educated participants (group 1). The gray shades in different areas represent atrophy, and the level of gray intensity indicates the degree of atrophy. Our analysis shows a significantly lower glucose metabolic rate in the following brain areas of the less-educated dementia group: middle temporal gyrus, middle frontal gyrus, superior frontal gyrus, inferior frontal gyrus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, middle occipital gyrus, rectal gyrus, and lingual gyrus (Table 2). For clarification, the data in Figure 2 are summarized in Table 2.

Bottom Line: Nevertheless, mild DAT in illiterate participants seems to be due to brain atrophy.In this study, we compared the impact of brain metabolism efficiency in healthy participants and less-educated patients with mild DAT using 2-fluoro-2-deoxy-D-glucose (F-FDG-PET) positron emission tomography.Participants with intracranial insults were excluded by brain magnetic resonance imaging and participants with metabolic or systemic conditions were excluded by blood sampling.The PET imaging data were analyzed using statistical parametric mapping (SPM8) to determine reliability and specificity.Glucose metabolic rate was low in the DAT group, especially in the middle temporal gyrus, middle frontal gyrus, superior frontal gyrus, inferior frontal gyrus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, middle occipital gyrus, rectal gyrus, and lingual gyrus.Our results showed that DAT patients with less education not only have prominent clinical signs and symptoms related to dementia but also decreased gray matter metabolism.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neurology (YCH), Chang Bing Show Chwan Memorial Hospital; Department of Bioindustry Technology (YCH, STW), Dayeh University, Chang Hua; Department of Neurology (YCH), Taoyuan General Hospital, Ministry of Health and Welfare, Executive Yuan; Asian Institute of TeleSurgery (AITS) (JTC), Show Chwan Healthcare System; Department of Nuclear Medicine (GUH), Chang Bing Show Chwan Memorial Hospital; Department of Nuclear Medicine and PET Center (CHK), China Medical University Hospital; Graduate Institute of Clinical Medical Science and School of Medicine (CHK), College of Medicine, China Medical University, Taichung; Department of Radiology (TYC), Chang Bing Show Chwan Memorial Hospital; and Department of Internal Medicine (PSY, FMH), Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.

ABSTRACT
Alzheimer dementia (AD) is the commonest form of dementia. Although illiteracy is associated with high prevalence of dementia of the Alzheimer type (DAT), their relationship is still unclear. Nevertheless, mild DAT in illiterate participants seems to be due to brain atrophy.In this study, we compared the impact of brain metabolism efficiency in healthy participants and less-educated patients with mild DAT using 2-fluoro-2-deoxy-D-glucose (F-FDG-PET) positron emission tomography. Out of 43 eligible less-educated participants with dementia, only 23 (14 women and 9 men) met Diagnostic and Statistical Manual (DSM)-III-R or DSM-IV criteria for DAT and AD and were included. Participants with intracranial insults were excluded by brain magnetic resonance imaging and participants with metabolic or systemic conditions were excluded by blood sampling. In addition, 16 cognitively normal elderly (age >70 years), including 7 women and 9 men, were enrolled in the sham group. The PET imaging data were analyzed using statistical parametric mapping (SPM8) to determine reliability and specificity.Glucose metabolic rate was low in the DAT group, especially in the middle temporal gyrus, middle frontal gyrus, superior frontal gyrus, inferior frontal gyrus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, middle occipital gyrus, rectal gyrus, and lingual gyrus.Our results showed that DAT patients with less education not only have prominent clinical signs and symptoms related to dementia but also decreased gray matter metabolism.

Show MeSH
Related in: MedlinePlus