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Parietal lobe changes are important in AD

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. Background. 63 Years Male. 12 years edu. father dementia. 2008 MMSE 26 Moca 20 ADL 21.

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Parietal lobe changes are important in AD

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  1. 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

  2. Background 63 Years Male. 12 years edu. father dementia 2008 MMSE 26 Moca20 ADL21 2010 MMSE22 Moca17 ADL24 Spatial disorientation confabulation Acalculia Memory disturbance mild disorientation Clinical MMSE MOCA ADL PUMCH BEIJING CHINA

  3. Background PUMCH BEIJING CHINA

  4. 2010 2008 PUMCH BEIJING CHINA

  5. Aim : AD diagnosis and parietal lobe FDG-PET metabolic Glucose hypometabolism? MRI cortical Parietal lobe Atrophy? White matter Axon or myelin degeneration? PUMCH BEIJING CHINA

  6. Method : probable AD patients patients enrolled: Acoording to the NINCDS-ADRDA 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 Extensive laboratory testing CBC, chemistry, vitamin B12 /folate, syphilis serology, thyroid function tests and Hu,Yo, Ri PUMCH BEIJING CHINA

  7. 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

  8. Results: Dementia 123 AD,FTD,PCA, Mixed, Others Probable AD 41 Probable mixed AD 43 Enrolled Patients PUMCH BEIJING CHINA

  9. Results: Hypometabolism post cingulate 79.4% MTL 52-62% Parietal 92.3-100 % post temporo-parietal 54-72% FDG-PETof probable AD and mixed PUMCH BEIJING CHINA

  10. Method : 3D MRI VBM visual rating DT I Parietal lobe atrophy PUMCH BEIJING CHINA

  11. Atrophy seen on at least 4 cuts MTL 26.7%-35.6% parietal lobe atrophy 67.8%-84.4% PUMCH BEIJING CHINA

  12. Normal control AD patients PUMCH BEIJING CHINA

  13. 24 pure AD readible VBM MRI compared to controls PUMCH BEIJING CHINA

  14. 24 pure AD readible VBM MRI compared to controls PUMCH BEIJING CHINA

  15. DTI (N=10) Control • Probable AD PUMCH BEIJING CHINA

  16. Parietal lobe hypometabolism occurred earlier(n=1) 2008 2007 PUMCH BEIJING CHINA

  17. Another case Parietal lobe hypometabolism occurred earlier 2009 2011 PUMCH BEIJING CHINA

  18. 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

  19. Discussion Parietal lobe is a good target to detect AD (atrophy and hypometabolism) Parietal lobe is important for cognition PUMCH BEIJING CHINA

  20. Parietal lobe is more sensitive The latest report : Kyle B. Womack 2011 march (SSP) Temporoparietal lobe Hypometabolism Sensitivity : 93.6 (78.6-99.2) % Our finding: • Parietal lobe is more sensitive Temporoparietal lobe Parietal lobe 92-100%post temporoparietal lobe54- 72% PUMCH BEIJING CHINA

  21. Parietal lobe earlier? previously published hypometablism starts in the posterior cingulate gyrus ,then extends to the hippocampus and parahippocampal gyrus -------Kogure et al., 2000 Our findings • Parietal lobe hypometabolism occurs earlier than posterior cingulate 2008 2009 PUMCH BEIJING CHINA

  22. Parietal lobe Language memory construction praxis Parietal lobe and cognition calculation Associated with higher cortical function PUMCH BEIJING CHINA

  23. CONCLUSION Parietal lobe hypometabolism and atrophy could be valuable for AD diagnosis. We hope further studies will confirm our findings Description of the contents PUMCH BEIJING CHINA

  24. THANK YOU . PUMCH BEIJING CHINA

  25. WML: FDG-PET, DTI , cognitive normal White matter changing on routine MRI could be does not matter PUMCH BEIJING CHINA

  26. Dementia : AD mixd ? PUMCH BEIJING CHINA

  27. Method : MTL atrophy EPILEPSY withMTL RESECTION without FCD Before After OPERATION Probable AD Imaging only follow up and Compare the cognition PUMCH BEIJING CHINA

  28. HS PUMCH BEIJING CHINA

  29. 执行功能： 列名 正常 障碍（轻 重） 数字符号 正常 异常 （轻 重） 接龙测验 A 正常 异常 （轻 重） B 正常 异常 （轻 重） 未作 画钟 正 异 轻/重 临摹 正 异轻/重 视空间 视保持测验 正常 异常 轻 重 临摹 正常 异常 轻 重 积木测验正常 异常轻 重 语言（高素荣汉语失语症检查法口语部分） 自发语言， 流利 非流利； 命名 正 异轻/重 错语 有 偶有 复述，正常 异常 轻 重； 听指令执行 正常 异常 轻 重 记忆 联想学习 正常 异常 轻 重 视保持测验 正常 异常 轻 重； 情景记忆数 听辨认正确数 概念推理以及计算 相似性测验 正常 异常 轻 重 计算 正常 异常 轻 重 动作模仿 单个 正确数 系列 正确数 结果： 单项认知功能 (遗忘 非遗忘） 轻度障碍 障碍 多项认知功能 轻度障碍 障碍 PUMCH SYSTEM NEUROPSYCHOLOGY BATTERY PUMCH BEIJING CHINA

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