Jack C R, Petersen R C, Xu Y C, O'Brien P C, Smith G E, Ivnik R J, Boeve B F, Waring S C, Tangalos E G, Kokmen E
Department of Diagnostic Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Neurology. 1999 Apr 22;52(7):1397-403. doi: 10.1212/wnl.52.7.1397.
To test the hypothesis that MRI-based measurements of hippocampal volume are related to the risk of future conversion to Alzheimer's disease (AD) in older patients with a mild cognitive impairment (MCI).
Patients who develop AD pass through a transitional state, which can be characterized as MCI. In some patients, however, MCI is a more benign condition, which may not progress to AD or may do so slowly.
Eighty consecutive patients who met criteria for the diagnosis of MCI were recruited from the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry.
At entry into the study, each patient received an MRI examination of the head, from which the volumes of both hippocampi were measured. Patients were followed longitudinally with approximately annual clinical/cognitive assessments. The primary endpoint was the crossover of individual MCI patients to the clinical diagnosis of AD during longitudinal clinical follow-up.
During the period of longitudinal observation, which averaged 32.6 months, 27 of the 80 MCI patients became demented. Hippocampal atrophy at baseline was associated with crossover from MCI to AD (relative risk [RR], 0.69, p = 0.015). When hippocampal volume was entered into bivariate models-using age, postmenopausal estrogen replacement, standard neuropsychological tests, apolipoprotein E (APOE) genotype, history of ischemic heart disease, and hypertension-the RRs were not substantially different from that found univariately, and the associations between hippocampal volume and crossover remained significant.
In older patients with MCI, hippocampal atrophy determined by premorbid MRI-based volume measurements is predictive of subsequent conversion to AD.
检验基于磁共振成像（MRI）测量海马体体积与轻度认知障碍（MCI）老年患者未来转化为阿尔茨海默病（AD）风险相关的假设。
发展为AD的患者会经历一个过渡状态，即MCI。然而，在一些患者中，MCI是一种更良性的状况，可能不会进展为AD，或者进展缓慢。
从梅奥诊所阿尔茨海默病中心/阿尔茨海默病患者登记处招募了连续80例符合MCI诊断标准的患者。
在研究开始时，每位患者接受头部MRI检查，测量双侧海马体体积。对患者进行纵向随访，大约每年进行临床/认知评估。主要终点是个体MCI患者在纵向临床随访期间转化为AD的临床诊断。
在平均32.6个月的纵向观察期内，80例MCI患者中有27例出现痴呆。基线时的海马体萎缩与从MCI转化为AD相关（相对风险[RR]，0.69，p = 0.015）。当将海马体体积纳入双变量模型时（使用年龄、绝经后雌激素替代、标准神经心理学测试、载脂蛋白E（APOE）基因型、缺血性心脏病史和高血压），RR与单变量分析时没有显著差异，海马体体积与转化之间的关联仍然显著。
在患有MCI的老年患者中，基于病前MRI体积测量确定的海马体萎缩可预测随后转化为AD。
