Teipel S J, Bayer W, Alexander G E, Bokde A L W, Zebuhr Y, Teichberg D, Müller-Spahn F, Schapiro M B, Möller H-J, Rapoport S I, Hampel H
Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr 7, 80336, Munich, Germany.
Neurobiol Aging. 2003 Jan-Feb;24(1):85-94. doi: 10.1016/s0197-4580(02)00044-1.
We used volumetric MRI and analysis of areas under receiver operating characteristic (ROC) curves to directly compare the extent of hippocampus-amygdala formation (HAF) and corpus callosum atrophy in patients with Alzheimer's disease (AD) in different clinical stages of dementia. Based on neuropathological studies, we hypothesized that HAF atrophy, representing allocortical neuronal degeneration, would precede atrophy of corpus callosum, representing loss of neocortical association neurons, in early AD. HAF and corpus callosum sizes were significantly reduced in 27 AD patients (37% and 16%, respectively) compared to 28 healthy controls. In mildly- and moderately-demented AD patients, the ROC derived index of atrophy was greater for HAF volume than for total corpus callosum area. The index of atrophy of posterior corpus callosum was not significantly different from HAF at mild, moderate or severe stages of dementia. In conclusion, these findings suggest a characteristic regional pattern of allocortical and neocortical neurodegeneraton in AD. Our data indicate that neuronal loss in parietotemporal cortex (represented by atrophy of corpus callosum splenium) may occur simultaneously with allocortical neurodegeneration in mild AD. Moreover, ROC analysis may provide a statistical framework to determine atrophy patterns of different brain structures in neurodegenerative diseases in vivo.
我们使用容积磁共振成像（MRI）和对接受者操作特征（ROC）曲线下面积的分析，直接比较不同痴呆临床阶段的阿尔茨海默病（AD）患者海马-杏仁核结构（HAF）和胼胝体萎缩的程度。基于神经病理学研究，我们假设在早期AD中，代表异皮质神经元变性的HAF萎缩会先于代表新皮质联合神经元丧失的胼胝体萎缩。与28名健康对照相比，27名AD患者的HAF和胼胝体大小显著减小（分别为37%和16%）。在轻度和中度痴呆的AD患者中，基于ROC得出的HAF体积萎缩指数大于胼胝体总面积萎缩指数。在痴呆的轻度、中度或重度阶段，胼胝体后部萎缩指数与HAF无显著差异。总之，这些发现提示了AD中异皮质和新皮质神经退行性变的特征性区域模式。我们的数据表明，顶颞叶皮质的神经元丢失（以胼胝体压部萎缩为代表）可能在轻度AD中与异皮质神经退行性变同时发生。此外，ROC分析可能为在体内确定神经退行性疾病中不同脑结构的萎缩模式提供一个统计框架。
