Metabolic Asymmetry Relates to Clinical Characteristics and Brain Network Abnormalities in Alzheimer’s Disease

Author:

Lin Huamei12,Pan Tingting3,Wang Min4,Ge Jingjie12,Lu Jiaying12,Ju Zizhao12,Chen Keliang25,Zhang Huiwei12,Guan Yihui12,Zhao Qianhua25,Shan Baoci3,Nie Binbin3ORCID,Zuo Chuantao12ORCID,Wu Ping12ORCID

Affiliation:

1. Deparment of Nuclear Medicine / PET Center, Huashan Hospital, Fudan University, Shanghai, China

2. National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China

3. Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High EnergyPhysics, Chinese Academy of Sciences, Beijing, China

4. Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China

5. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China

Abstract

Background: Metabolic asymmetry has been observed in Alzheimer’s disease (AD), but different studies have inconsistent viewpoints. Objective: To analyze the asymmetry of cerebral glucose metabolism in AD and investigate its clinical significance and potential metabolic network abnormalities. Methods: Standardized uptake value ratios (SUVRs) were obtained from 18F-FDG positron emission tomography (PET) images of all participants, and the asymmetry indices (AIs) were calculated according to the SUVRs. AD group was divided into left/right-dominant or bilateral symmetric hypometabolism (AD-L/AD-R or AD-BI) when more than half of the AIs of the 20 regions of interest (ROIs) were < –2SD, >2SD, or between±1SD. Differences in clinical features among the three AD groups were compared, and the abnormal network characteristics underlying metabolic asymmetry were explored. Results: In AD group, the proportions of AD-L, AD-R, and AD-BI were 28.4%, 17.9%, and 18.5%, respectively. AD-L/AD-R groups had younger age of onset and faster rate of cognitive decline than AD-BI group (p < 0.05). The absolute values of AIs in half of the 20 ROIs became higher at follow-up than at baseline (p < 0.05). Compared with those in AD-BI group, metabolic connection strength of network, global efficiency, cluster coefficient, degree centrality and local efficiency were lower, but shortest path length was longer in AD-L and AD-R groups (p < 0.05). Conclusion: Asymmetric and symmetric hypometabolism may represent different clinical subtypes of AD, which may provide a clue for future studies on the heterogeneity of AD and help to optimize the design of clinical trials.

Publisher

IOS Press

Subject

Psychiatry and Mental health,Geriatrics and Gerontology,Clinical Psychology,General Medicine,General Neuroscience

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