Presentation on theme: "LOGO Parietal lobe changes are important in AD Jing gao fang li fenfeng liying cui et al Peking Union medical colleage hospital Chinese academy of medicine."— Presentation transcript:
LOGO Parietal lobe changes are important in AD Jing gao fang li fenfeng liying cui et al Peking Union medical colleage hospital Chinese academy of medicine science Beijng china
PUMCH BEIJING CHINA Background MMSE MOCA ADL Clinical 2008 MMSE 26 Moca 20 ADL 21 2010 MMSE 22 Moca 17 ADL 24 Spatial disorientation confabulation Acalculia Memory disturbance mild disorientation 63 Years Male. 12 years edu. father dementia
PUMCH BEIJING CHINA Aim : AD diagnosis and parietal lobe Glucose hypometabolism? Atrophy? FDG-PET metabolic MRI cortical White matter Parietal lobe Axon or myelin degeneration?
PUMCH BEIJING CHINA Method : probable AD patients Detailed and reliable clinical history “step by step” cognitive assessment “screening” by MMSE, MOCA, and ADL,HAD detailed neuropsychological assessment Special domain assessment if needed : aphasia, agnosia etc patients enrolled: Acoording to the NINCDS-ADRDA Extensive laboratory testing Extensive laboratory testing CBC, chemistry, vitamin B12 /folate, syphilis serology, thyroid function tests and Hu,Yo, Ri
PUMCH BEIJING CHINA Method :IMAGING 3 D MRI ROUTINE TEST : T1 T2 Flare VBM DTI GRE MRS and fMRI of resting state FDG-PET visual rating, SUV, NeuroQ
PUMCH BEIJING CHINA Results: Enrolled Patients Probable AD 41 Probable mixed AD 43 Dementia 123 AD,FTD,PCA, Mixed, Others
PUMCH BEIJING CHINA Results: Hypometabolism FDG-PETof probable AD and mixed MTL 52-62% Parietal 92.3-100 % post cingulate 79.4% post temporo-parietal 54-72%
PUMCH BEIJING CHINA Method : 3D MRI Parietal lobe atrophy visual rating DT I VBM
PUMCH BEIJING CHINA Atrophy seen on at least 4 cuts MTL 26.7%-35.6% parietal lobe atrophy 67.8%-84.4%
PUMCH BEIJING CHINA Another case Parietal lobe hypometabolism occurred earlier 2009 2011
PUMCH BEIJING CHINA Parietal lobe earlier than clinic??? 2000 MQ 91, pared association learning and episodic memory mild disturbance BVRT normal 2010 MQ 80 MMSE 28 Moca 24 ADL 20 system assessment is only aMCI Visual rating : pairetal lobe hypomatebolism SUV :( compare to base of pon ) parietal lobe reduced
PUMCH BEIJING CHINA Discussion Parietal lobe is a good target to detect AD ( atrophy and hypometabolism) Parietal lobe is important for cognition
PUMCH BEIJING CHINA Parietal lobe is more sensitive The latest report : Kyle B. Womack 2011 march (SSP) Temporoparietal lobe Hypometabolism Sensitivity : 93.6 (78.6-99.2) % Temporoparietal lobe Parietal lobe 92-100% post temporoparietal lobe54- 72% Our finding: Parietal lobe is more sensitive
PUMCH BEIJING CHINA Parietal lobe earlier? previously published hypometablism starts in the posterior cingulate gyrus,then extends to the hippocampus and parahippocampal gyrus -------Kogure et al., 2000 2008 2009 Our findings Parietal lobe hypometabolism occurs earlier than posterior cingulate
PUMCH BEIJING CHINA Parietal lobe and cognition construction memory praxisLanguage Parietal lobe Associated with higher cortical function calculation
PUMCH BEIJING CHINA CONCLUSION Description of the contents We hope further studies will confirm our findings Parietal lobe hypometabolism and atrophy could be valuable for AD diagnosis.
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