A substantial amount of amyloid-beta (Aβ) accumulates in the occipital cortices; however, it draws less attention. We investigated the clinical implications of Aβ accumulation in the occipital lobes in the Alzheimer’s disease (AD) continuum. [18F]-Florbetaben amyloid PET scans were performed in a total of 121 AD or amnestic mild cognitive impairment (aMCI) patients. Of the 121 patients, 74 Aβ positive patients were divided into occipital Aβ positive (OCC+) and occipital Aβ negative (OCC−) groups based on Aβ accumulation in the bilateral occipital lobes. The OCC+ group (41/74, 55.4%) was younger and had a younger age at onset than the OCC− group. The OCC+ group also had an increased standard uptake value ratio in the occipital lobes and greater cortical thinning in relevant areas. The OCC+ group had a higher global deterioration scale, lower performance for the copy, immediate recall, delayed recall, and recognition in Rey–Osterrieth Complex Figure tests than the OCC- group, although both groups had similar disease durations. AD or aMCI patients in the OCC+ group exhibited features noted in early onset AD with relevant neuropsychological and image findings. Occipital Aβ positivity in amyloid PET scans need to be considered as an underestimated marker of early onset AD continuum.

中文翻译：

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阿尔茨海默病连续体枕叶淀粉样蛋白-β 积累的临床意义

大量的淀粉样蛋白-β (Aβ) 积聚在枕叶皮质中；然而，它引起的关注较少。我们研究了阿尔茨海默病 (AD) 连续体中枕叶中 Aβ 积累的临床意义。[18F]-Florbetaben 淀粉样蛋白 PET 扫描在总共 121 名 AD 或遗忘型轻度认知障碍 (aMCI) 患者中进行。在 121 名患者中，74 名 Aβ 阳性患者根据双侧枕叶中的 Aβ 积累分为枕部 Aβ 阳性（OCC+）和枕部 Aβ 阴性（OCC-）组。OCC+组（41/74，55.4%）比OCC-组更年轻，发病年龄也更小。OCC+ 组的枕叶标准摄取值比率也增加，相关区域的皮质变薄程度更大。OCC+组有更高的全球恶化规模，在 Rey-Osterrieth 复杂图形测试中，复制、立即回忆、延迟回忆和识别的表现低于 OCC-组，尽管两组的疾病持续时间相似。OCC+ 组中的 AD 或 aMCI 患者表现出早发性 AD 中注意到的特征以及相关的神经心理学和图像发现。淀粉样蛋白 PET 扫描中的枕骨 Aβ 阳性需要被视为早发性 AD 连续谱的低估标志物。