Teipel S J, Hampel H, Pietrini P, Alexander G E, Horwitz B, Daley E, Möller H J, Schapiro M B, Rapoport S I
Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
Arch Neurol. 1999 Apr;56(4):467-73. doi: 10.1001/archneur.56.4.467.
Positron emission tomographic studies of patients with Alzheimer disease (AD) suggest a loss of metabolic functional interactions between different cortical regions. Atrophy of the corpus callosum as the major tract of intracortical connective fibers may reflect decreased cortical functional integration in AD.
To investigate whether regional atrophy of the corpus callosum is correlated with regional reductions of cortical glucose metabolism, as shown by positron emission tomography, and whether primary white matter degeneration is a possible cofactor of corpus callosum atrophy in AD.
We measured total and regional cross-sectional areas of the corpus callosum on midsagittal magnetic resonance imaging scans from 12 patients with AD and 15 age-matched control subjects. Regional cerebral metabolic rates for glucose in cortical lobes were measured by positron emission tomography using fludeoxyglucose F 18. White matter hyperintensities were rated in T2-weighted magnetic resonance imaging scans.
The total cross-sectional area of corpus callosum was significantly reduced in patients with AD, with the most prominent changes in the rostrum and splenium and relative sparing of the body of the corpus callosum. Frontal and parietal lobe metabolism was correlated with the truncal area of the corpus callosum in AD. The ratios of frontal to parietal and of frontal to occipital metabolism were correlated with the ratio of anterior to posterior corpus callosum area in the group with AD. White matter hyperintensities did not correlate with corpus callosum atrophy in the patients with AD.
The regional pattern of corpus callosum atrophy correlated with reduced regional glucose metabolism independently of primary white matter degeneration in the patients with AD.
对阿尔茨海默病(AD)患者进行的正电子发射断层扫描研究表明,不同皮质区域之间的代谢功能相互作用丧失。胼胝体作为皮质内连接纤维的主要通道发生萎缩,可能反映了AD患者皮质功能整合的下降。
研究胼胝体区域萎缩是否与正电子发射断层扫描所示的皮质葡萄糖代谢区域降低相关,以及原发性白质变性是否可能是AD患者胼胝体萎缩的一个辅助因素。
我们在12例AD患者和15例年龄匹配的对照受试者的矢状位磁共振成像扫描上测量了胼胝体的整体和区域横截面积。使用氟脱氧葡萄糖F 18通过正电子发射断层扫描测量皮质叶的区域脑葡萄糖代谢率。在T2加权磁共振成像扫描中对白质高信号进行评分。
AD患者的胼胝体总横截面积显著减小,其中嘴部和压部变化最为明显,胼胝体体部相对保留。AD患者额叶和顶叶代谢与胼胝体的躯干区域相关。AD组中额叶与顶叶以及额叶与枕叶代谢的比率与胼胝体前后面积的比率相关。AD患者的白质高信号与胼胝体萎缩无关。
AD患者胼胝体萎缩的区域模式与区域葡萄糖代谢降低相关,且独立于原发性白质变性。