Frisoni G B, Testa C, Zorzan A, Sabattoli F, Beltramello A, Soininen H, Laakso M P
Laboratory of Epidemiology and Neuroimaging, IRCCS San Giovanni di Dio-FBF, Brescia, Italy.
J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):657-64. doi: 10.1136/jnnp.73.6.657.
To test the applicability of an automated method of magnetic resonance image analysis (voxel based morphometry) to detect presence and severity of regional grey matter density reduction-a proxy of atrophy-in Alzheimer's disease.
Twenty nine probable Alzheimer's patients and 26 non-demented controls (mini-mental state examinations mean (SD) 21 (4) and 29 (1)) underwent high resolution 3D brain magnetic resonance imaging. Spatial normalisation to a stereotactic template, segmentation into grey matter, white matter, and cerebrospinal fluid, and smoothing of the grey matter were carried out based on statistical parametric mapping (SPM99) algorithms. Analyses were carried out: (a) contrasting all Alzheimer's patients with all controls (p<0.05 corrected for multiple comparisons); (b) contrasting the three Alzheimer's patients with mini-mental state of 26 and higher with all controls (p<0.0001 uncorrected); and (c) correlating grey matter density with mini-mental state score within the Alzheimer's group (p<0.0001 uncorrected).
When all Alzheimer's patients were compared with controls, the largest atrophic regions corresponded to the right and left hippocampal/amygdalar complex. All parts of the hippocampus (head, body, and tail) were affected. More localised atrophic regions were in the temporal and cingulate gyri, precuneus, insular cortex, caudate nucleus, and frontal cortex. When the mildest Alzheimer's patients were contrasted with controls, the hippocampal/amygdalar complex were again found significantly atrophic bilaterally. The mini-mental state score correlated with grey matter density reduction in the temporal and posterior cingulate gyri, and precuneus, mainly to the right.
Voxel based morphometry with statistical parametric mapping is sensitive to regional grey matter density reduction in mild Alzheimer's disease.
测试一种磁共振图像分析的自动化方法（基于体素的形态测量法）用于检测阿尔茨海默病中局部灰质密度降低（萎缩的一种替代指标）的存在及严重程度的适用性。
29例很可能患有阿尔茨海默病的患者和26名非痴呆对照者（简易精神状态检查平均（标准差）分别为21（4）和29（1））接受了高分辨率3D脑磁共振成像检查。基于统计参数映射（SPM99）算法进行了立体定向模板的空间归一化、灰质、白质和脑脊液的分割以及灰质的平滑处理。分析如下：（a）将所有阿尔茨海默病患者与所有对照者进行对比（经多重比较校正后p<0.05）；（b）将简易精神状态评分为26分及以上的3例阿尔茨海默病患者与所有对照者进行对比（未校正p<0.0001）；（c）在阿尔茨海默病组内将灰质密度与简易精神状态评分进行相关性分析（未校正p<0.0001）。
当将所有阿尔茨海默病患者与对照者进行比较时，最大的萎缩区域对应于右侧和左侧海马体/杏仁核复合体。海马体的所有部分（头部、体部和尾部）均受影响。更局限的萎缩区域位于颞叶和扣带回、楔前叶、岛叶皮质、尾状核和额叶皮质。当将病情最轻的阿尔茨海默病患者与对照者进行对比时，再次发现双侧海马体/杏仁核复合体明显萎缩。简易精神状态评分与颞叶和后扣带回以及楔前叶的灰质密度降低相关，主要在右侧。
基于体素的形态测量法结合统计参数映射对轻度阿尔茨海默病中的局部灰质密度降低敏感。
