Authors: Claudio Liguori Agostino Chiaravalloti Giuseppe Sancesario Alessandro Stefani Giulia Maria Sancesario Nicola Biagio Mercuri Orazio Schillaci Mariangela Pierantozzi
Publish Date: 2016/05/25
Volume: 43, Issue: 11, Pages: 2040-2049
Abstract
It has been suggested that neuronal energy metabolism may be involved in Alzheimer’s disease AD In this view the finding of increased cerebrospinal fluid CSF lactate levels in AD patients has been considered the result of energetic metabolism dysfunction Here we investigated the relationship between neuronal energy metabolism as measured via CSF lactate levels and cerebral glucose metabolism as stated at the 2deoxy218FfluoroDglucose positron emission tomography 18FFDG PET in AD patientsAD patients underwent lumbar puncture to measure CSF lactate levels and 18FFDG PET to assess brain glucose metabolism CSF and PET data were compared to controls Since patients were studied at rest we specifically investigated brain areas active in restcondition owing to the Default Mode Network DMN We correlated the CSF lactate concentrations with the 18FFDG PET data in brain areas owing to the DMN using sex age disease duration Mini Mental State Examination and CSF levels of tau proteins and betaamyloid as covariatesAD patients n = 32 showed a significant increase of CSF lactate levels compared to Control 1 group n = 28 They also showed brain glucose hypometabolism in the DMN areas compared to Control 2 group n = 30 Within the AD group we found the significant correlation between increased CSF lactate levels and glucose hypometabolism in Broadman areas BA owing to left medial prefrontal cortex BA10 mPFC left orbitofrontal cortex BA11 OFC and left parahippocampal gyrus BA 35 PHGWe found high CSF levels of lactate and glucose hypometabolism within the DMN in AD patients Moreover we found a relationship linking the increased CSF lactate and the reduced glucose consumption in the left mPFC OFC and PHG owing to the anterior hub of DMN These findings could suggest that neural glucose hypometabolism may affect the DMN efficiency in AD also proposing the possible role of damaged brain energetic machine in impairing DMN
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