상위피인용논문
울산대학교 의과대학, 서울아산병원
Lee, J.H.a, Kim, S.H.c, Kim, G.H.d, Seo, S.W.d, Park, H.K.a,e, Oh, S.J.b, Kim, J.S.b, Cheong, H.K.f, Na, D.L.d
aDepartment of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
bDepartment of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
cDepartment of Neurology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, South Korea
dDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea
eDepartment of Neurology, Inje University Ilsan Paik Hospital, Goyang, South Korea
fDepartment of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
Address correspondence and reprint requests to Dr. Duk L. Na
Abstract
Background: Subcortical vascular dementia (SVaD) is considered the most common type of vascular dementia and often follows a slowly progressive course, simulating Alzheimer disease (AD). Whether the progressive cognitive decline is associated with pure SVaD or concomitant AD remains unknown. The purpose of this study was to determine what proportion of patients with SVaD lack abnormal amyloid imaging, and to examine differences in the clinical or MRI features between subjects with SVaD with cortical amyloid deposition and those without.
Methods: We measured brain amyloid deposition using 11C-Pittsburgh compound B (PiB) PET in 45 patients (men: women = 19:26; mean age 74.2 ± 7.6 years) with SVaD. They all met DSM-IV criteria for vascular dementia and had severe white matter high signal intensities without territorial infarction or macrohemorrhage on MRI.
Results: Thirty-one (68.9%) of 45 patients with SVaD were negative for cortical PiB binding. There was significant difference between 11C-PiB-positive and 11C-PiB-negative groups in terms of age (79.5 vs 71.9 years), Mini-Mental State Examination score (18.6 vs 22.6), the number of lacunes (3.9 vs 9.0), and the visual rating scale of hippocampal atrophy (3.1 vs 2.3). The neuropsychological assessments revealed that patients with 11C-PiB-negative SVaD performed better on the delayed recall of both the verbal and visual memory test than did those with 11C-PiB-positive scan.
Conclusion: SVaD without abnormal amyloid imaging was more common than expected. Patients with SVaD with and without abnormal amyloid imaging differed in clinical and MRI features, although there was considerable overlap.
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