title: Brain Metabolism of Less-Educated Patients With Alzheimer Dementia Studied by Positron Emission Tomography.
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.
authors.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.
authors.forename: Yu Ching
authors.initials: YC
authors.lastname: Huang
authors.forename: Pao Sheng
authors.initials: PS
authors.lastname: Yen
authors.forename: Shwu Tzy
authors.initials: ST
authors.lastname: Wu
authors.forename: Jung Tai
authors.initials: JT
authors.lastname: Chen
authors.forename: Gung Uei
authors.initials: GU
authors.lastname: Hung
authors.forename: Chia Hung
authors.initials: CH
authors.lastname: Kao
authors.forename: Tai Yee
authors.initials: TY
authors.lastname: Chen
authors.forename: Feng Ming
authors.initials: FM
authors.lastname: Ho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D001928:Brain Diseases, Metabolic / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose