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アルツハイマー病、他の認知症、老化 1
Alzheimer's Disease, Other Dementia, Aging 1

開催日 2014/9/11
時間 14:00 - 15:00
会場 Room I(311+312)
Chairperson(s) 植木 孝俊 / Takatoshi Ueki (名古屋市立大学大学院医学研究科機能解剖学分野 / Department of Functional Anatomy, Nagoya City University Graduate School of Medical Sciences, Japan)
髙橋 淳 / Jun C. Takahashi (国立循環器病研究センター 脳神経外科 / Department of Neurosurgery, National Cerebral and Cardiovascular Center, Japan)

Amyloid deposits and response to shunt therapy in idiopathic normal-pressure hydrocephalus

  • O1-I-3-4
  • 平岡 宏太良 / Kotaro Hiraoka:1 成田 渉 / Wataru Narita:2 菊池 大一 / Hirokazu Kikuchi:2 馬場 徹 / Toru Baba:2 菅野 重範 / Shigenori Kanno:2 飯塚 統 / Osamu Iizuka:2 田代 学 / Manabu Tashiro:1 岡村 信行 / Nobuyuki Okamura:3 古川 勝敏 / Katsutosh Furukawa:4 荒井 啓行 / Hiroyuki Arai:4 岩田 錬 / Ren Iwata:5 谷内 一彦 / Kazuhiko Yanai:3 
  • 1:東北大学サイクロトロン・RIセンター / Division of Cyclotron Nuclear Medicine Cyclotron and Radioisotope Center, Tohoku University, Japan 2:東北大学医学部 高次機能障害学 / Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Japan 3:東北大学医学部 機能薬理学 / Department of Pharmacology, Tohoku University Graduate School of Medicine, Japan 4:東北大学医学部 老年医学 / Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Japan 5:東北大学サイクロトロン・RIセンター 核薬学研究部 / Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Japan 

Backgrounds: 18.5 to 67.6% of idiopathic normal-pressure hydrocephalus (iNPH) subjects showed Alzheimer pathology such as senile plaques in the studies using frontal lobe cortical biopsy during shunt surgery or intracranial pressure monitoring. In cases of diagnosing iNPH, comorbidity of or differential diagnosis from Alzheimer's disease (AD) are somteimes problems.
Objective: To detect amyloid deposits in the brain before shunt surgery.
Methods: Amyloid imaging using positron emission tomography (PET) and a radiolabeled pharmaceutical comound, 11C-BF227 was performed in 11 probale iNPH patients (age 76.7±3.1) before shunt surgery. The mean standard uptake value of neocortical regions including frontal, temporal and parietal lobes and posterior cingulate gyrus was measured. Using cerebellar hemispheres as reference regions, the mean standard uptake value ratio (SUVR) of neocortices were estimated, which was regarded as index of amyloid deposits in the neocortices. The results were compared with SUVRs of 10 normal elderly subjects (age 70±2.8) and 10 AD patients (age 69.9±5.9) who underwent 11C-BF227-PET imaging previously.
Results: The SUVR of iNPH patients, normal elderly subjects, and AD patients were 1.13±0.073, 1.09±0.035, 1.24±0.053, respectively. In iNPH cases, cortical SUVR showed significant negative correlation with cognitive improvement after shunt surgery. (partial correlation, education as a covariate, p<0.05)
Conclusions: Accumulation of amyloid in the brain may attenuate cognitive improvement after shunt surgery. 11C-BF227-PET may be useful for predicting shunt response.

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