Du A T, Schuff N, Laakso M P, Zhu X P, Jagust W J, Yaffe K, Kramer J H, Miller B L, Reed B R, Norman D, Chui H C, Weiner M W
Magnetic Resonance Unit, Department of Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
Neurology. 2002 Jun 11;58(11):1635-41. doi: 10.1212/wnl.58.11.1635.
To determine the effects of subcortical ischemic vascular dementia (SIVD) and AD on entorhinal cortex (ERC) and hippocampus.
Thirty-eight cognitively normal subjects, 18 patients with SIVD, and 22 patients with AD were included. Volumes of ERC and hippocampus were manually measured based on MRI. Global cerebral changes of cortical gray matter, subcortical gray matter, white matter, sulcal CSF, ventricular CSF (vCSF), and white matter signal hyperintensities (WMSH) were assessed.
Patients with SIVD had 21.7% (p < 0.01) smaller ERC and 18.2% (p < 0.01) smaller hippocampi than cognitively normal subjects and 24.4% (p < 0.01) larger ERC and 11.1% (p < 0.05) larger hippocampi than patients with AD. In addition, patients with SIVD had less cortical gray matter and white matter and more vCSF and WMSH (all p < 0.01) than cognitively normal subjects and more vCSF and WMSH (p < 0.01) than patients with AD. The volumes of ERC and hippocampus were positively correlated to similar extents (p < 0.01) in SIVD and AD. Cortical gray matter loss was positively correlated (p < 0.01) with hippocampal atrophy, but not with ERC atrophy, in SIVD and AD. Hippocampal volume alone could classify 82% of patients with SIVD from cognitively normal subjects and 63% of patients with SIVD from subjects with AD. Adding global cerebral changes to hippocampus substantially improved the classification to 96% between patients with SIVD and cognitively normal subjects and 83% between subjects with SIVD and those with AD, whereas adding ERC change to hippocampus did not significantly improve the discrimination.
The entorhinal cortex and hippocampus are less affected by subcortical ischemic vascular dementia than by AD.
确定皮质下缺血性血管性痴呆（SIVD）和阿尔茨海默病（AD）对内嗅皮质（ERC）和海马体的影响。
纳入38名认知正常受试者、18名SIVD患者和22名AD患者。基于磁共振成像（MRI）手动测量ERC和海马体的体积。评估皮质灰质、皮质下灰质、白质、脑沟脑脊液、脑室脑脊液（vCSF）和白质信号高增强（WMSH）的全脑变化。
与认知正常受试者相比，SIVD患者的ERC小21.7%（p<0.01），海马体小18.2%（p<0.01）；与AD患者相比，SIVD患者的ERC大24.4%（p<0.01），海马体大11.1%（p<0.05）。此外,与认知正常受试者相比，SIVD患者的皮质灰质和白质更少，vCSF和WMSH更多（均p<0.01）；与AD患者相比，SIVD患者的vCSF和WMSH更多（p<0.01）。在SIVD和AD中，ERC和海马体的体积在相似程度上呈正相关（p<0.01）。在SIVD和AD中，皮质灰质丢失与海马萎缩呈正相关（p<0.01），但与ERC萎缩无关。仅海马体体积就能将82%的SIVD患者与认知正常受试者区分开，将63%的SIVD患者与AD患者区分开。将全脑变化加入海马体后，SIVD患者与认知正常受试者之间的分类显著提高到96%，SIVD患者与AD患者之间的分类提高到83%，而将ERC变化加入海马体并未显著改善区分效果。
与AD相比，内嗅皮质和海马体受皮质下缺血性血管性痴呆的影响较小。
