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人体纹状体和苍白球的体积测量——解剖学、细胞结构、连接、磁共振成像与衰老

Volumetry of striatum and pallidum in man--anatomy, cytoarchitecture, connections, MRI and aging.

作者信息

Brabec J, Krásený J, Petrovický P

机构信息

Anatomical Institute of the 1st Medical Faculty, Charles University, U nemocnice 3, 128 00 Praha 2, Czech Republic.

出版信息

Sb Lek. 2003;104(1):13-65.

Abstract

BACKGROUND

For comparing of the pathological and normal healthy state it is essential to obtain sufficient amount of the volumetric data. Nevertheless most of the publicized works use only few healthy controls opposite to the patients for the measuring of the basal ganglia volume. Further essential condition is to take into account the effect of age to the basal ganglia volume in such analysis.

PURPOSE

The goal of our study was (1) to give the current review of the structure, neurotransmitters, connections and general integration of the basal ganglia in the pathways of the central nervous system, (2) aggregate sufficient amount of volumetric data by virtue of MRI and post-mortem studies, and appoint volumes of the striatum and pallidum, (3) evaluate aging of these structures in adult healthy patients. Another goal was (4) to inspect the correlations between the size of the basal ganglia and volume characteristics of the brain, cranial capacity or frequently measured dimensions within CNS. In the spite of the fact that it is not possible to measure all of these dimensions for clinicians who want to determine if the structure is "normal" or not. Another goal was (5) to find a simple measure, which could serve as the indicator of the real size of structure of the interest.

METHODS

By virtue of the classical anatomical methods and MRI examination we appointed volumes of the striatum (furthermore divided into the complex of the caudatum--nucleus accumbens--CD-Acc and putamen) and pallidum in the sample of 108 healthy adults (18-89 years old). From another measurements we calculated the cranial capacity and volume characteristics of each brain.

RESULTS

In a general view that does not respect changes due to age neither volumetric difference between two sexes nor interhemispheric difference was significant for absolute volumes of the striatum, CD-Acc complex, putamen and pallidum. In the case of the striatum, significant correlation between size and age was found (p < 0.0001) for absolute volumes in both sexes. In men, striatum showed a decrease about 14.3% in volume in the 20-50-year age range (about 4.8% per decade). In woman, the age related shrinkage is about 16.9% (about 5.6% per decade). Dependence on age was not statistically proven for volume of female complex CD-Acc (p = 0.061). Age related decrease of female putamen was about 23.15% in the 20-50 year age range (7.7% per decade). In men, the seizure decrease of the caudate--accumbens complex amounts 16.2%, in the same age range (5.4% per decade). Similarly, volume of the putamen in men decreases up to 12.3% between 20-50 years of age (4.1% per decade). In men, the pallidum showed a decrease about 21.6% in volume in the 20-50-year age range (7.2% per decade). In women, it amounts only 11.5% (3.8% per decade). Plane of the striatum in the level of the commissura anterior showed high correlation with total striatal volume (p < 0.0001, r = 0.668). The percentual portion of striatal volume at the level of the commissura anterior (1 cm thick slice) does not differ statistically between males and females. In our data it gives 28.56% (SD = 3.05). Correlation between the striatal planes and age was significant in both sexes (in women: p = 0.007, r = 0.348, and in men: p = 0.029, r = 0.349) as in the case of the correlation between striatal volume and age.

CONCLUSIONS

Our findings suggest that age mirror differently on separate structures in the brain. We have found unequal volume decrease within both sexes even particular nuclei. Our findings also suggest that decrease of the basal ganglia volume in the dependence on age is not linear but it is composed from periods without changes and periods with reduction of its size. In the case of the striatum, behaviour of changes looks similar (with only 5 years), while in the case of the pallidum this situation is markedly different. Our observations may suggest intersexual singularity in the aging of brain structures. From one MRI, from one frontal slice in the level of the commissura anterior is possible to reduce total volume of the striatum for every examined individual. Simple graph shows interval, where the normal value of this plain should be in dependency on age and sex of the examined patient. Another graph allows reducing from this plane the total volume of the striatum. These findings can be the quick and reliable aid in better diagnostics of different diseases.

摘要

背景

为了比较病理状态和正常健康状态,获取足够数量的体积数据至关重要。然而,大多数已发表的研究在测量基底神经节体积时,仅使用少量健康对照与患者进行对比。在此类分析中,另一个重要条件是考虑年龄对基底神经节体积的影响。

目的

我们研究的目的是:(1)对基底神经节在中枢神经系统通路中的结构、神经递质、连接和整体整合进行当前综述;(2)借助MRI和尸检研究汇总足够数量的体积数据,并确定纹状体和苍白球的体积;(3)评估成年健康患者中这些结构的老化情况。另一个目的是(4)检查基底神经节大小与脑体积特征、颅容量或中枢神经系统内经常测量的维度之间的相关性。尽管对于想要确定结构是否“正常”的临床医生来说,不可能测量所有这些维度。另一个目的是(5)找到一种简单的测量方法,可作为感兴趣结构实际大小的指标。

方法

通过经典解剖方法和MRI检查,我们确定了108名健康成年人(18 - 89岁)样本中纹状体(进一步分为尾状核 - 伏隔核 - CD - Acc复合体和壳核)和苍白球的体积。从其他测量中,我们计算了每个脑的颅容量和体积特征。

结果

总体而言,不考虑年龄变化、两性之间的体积差异以及半球间差异,纹状体、CD - Acc复合体、壳核和苍白球的绝对体积均无显著差异。就纹状体而言,发现两性的绝对体积与年龄之间存在显著相关性(p < 0.0001)。在男性中,纹状体在20 - 50岁年龄范围内体积减少约14.3%(每十年约4.8%)。在女性中,与年龄相关的萎缩约为16.9%(每十年约5.6%)。女性CD - Acc复合体的体积与年龄的相关性未得到统计学证实(p = 0.061)。女性壳核在20 - 50岁年龄范围内与年龄相关的减少约为23.15%(每十年7.7%)。在男性中,尾状核 - 伏隔核复合体在同一年龄范围内的减少量为16.2%(每十年5.4%)。同样,男性壳核在20 - 50岁之间体积减少高达12.3%(每十年4.1%)。在男性中,苍白球在20 - 50岁年龄范围内体积减少约21.6%(每十年7.2%)。在女性中,仅为11.5%(每十年3.8%)。前连合水平的纹状体平面与纹状体总体积高度相关(p < 0.0001,r = 0.668)。前连合水平(1厘米厚切片)的纹状体体积百分比在男性和女性之间无统计学差异。在我们的数据中,其为28.56%(标准差 = 3.05)。纹状体平面与年龄之间的相关性在两性中均显著(女性:p = 0.007,r = 0.348;男性:p = 0.029,r = 0.349),与纹状体体积和年龄之间的相关性情况相同。

结论

我们的研究结果表明,年龄对脑内不同结构的影响不同。我们发现两性甚至特定核团内的体积减少并不相等。我们的研究结果还表明,基底神经节体积随年龄的减少不是线性的,而是由无变化期和体积减小期组成。就纹状体而言,变化行为看起来相似(仅相差5年),而苍白球的情况则明显不同。我们的观察结果可能表明脑结构老化存在两性差异。从一次MRI检查中,从前连合水平的一个额叶切片可以为每个受检个体推算出纹状体的总体积。简单图表显示了该平面正常值应根据受检患者年龄和性别的区间。另一个图表允许根据该平面推算纹状体的总体积。这些发现可为更好地诊断不同疾病提供快速可靠的帮助。

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