Rusinek Henry, De Santi Susan, Frid Dina, Tsui Wai-Hon, Tarshish Chaim Y, Convit Antonio, de Leon Mony J
Department of Radiology, New York University School of Medicine, Bellevue C&D Bldg, Room D120, 550 First Ave, New York, NY 10016, USA.
Radiology. 2003 Dec;229(3):691-6. doi: 10.1148/radiol.2293021299.
To determine if medial temporal lobe (MTL) atrophy rate, assessed by using an automated procedure over the initial time interval of a 6-year, three-time-point longitudinal study, is predictive of future memory decline.
Healthy elderly subjects (age, >60 years) were administered a comprehensive battery of neuropsychometric tests and underwent magnetic resonance (MR) imaging at baseline and two or more follow-up examinations. The rate of brain atrophy between the baseline and first follow-up examinations was assessed by using an automated procedure that included spatial coregistration of the two images and regional brain boundary shift analysis. At final observation, the 45 subjects were separated into a group of those who did and a group of those who did not show objective evidence of cognitive decline. A forward stepwise logistic regression model was used to identify variables that predicted decline.
Thirty-two subjects remained healthy, and 13 showed cognitive decline. Among subjects who showed cognitive decline, six declined after the second observation. MTL atrophy rate, through its interactions with sex and age, was the most significant predictor of decline. The overall accuracy of prediction was 89% (in 40 of 45 subjects), with 91% specificity (in 29 of 32 subjects) and 85% sensitivity (in 11 of 13 subjects).
Among healthy elderly individuals, increased MTL atrophy rate appears to be predictive of future memory decline.
在一项为期6年、包含三个时间点的纵向研究的初始时间间隔内,通过自动化程序评估内侧颞叶(MTL)萎缩率,以确定其是否能预测未来的记忆衰退。
对健康的老年受试者(年龄>60岁)进行了一系列全面的神经心理测试,并在基线以及两次或更多次随访检查时进行了磁共振(MR)成像。通过使用一种自动化程序评估基线和首次随访检查之间的脑萎缩率,该程序包括对两张图像进行空间配准以及区域脑边界位移分析。在最终观察时,45名受试者被分为出现认知衰退客观证据的一组和未出现的一组。使用向前逐步逻辑回归模型来识别预测衰退的变量。
32名受试者保持健康,13名出现认知衰退。在出现认知衰退的受试者中,6名在第二次观察后出现衰退。MTL萎缩率通过与性别和年龄的相互作用,是衰退的最显著预测因素。预测的总体准确率为89%(45名受试者中的40名),特异性为91%(32名受试者中的29名),敏感性为85%(13名受试者中的11名)。
在健康的老年人中,MTL萎缩率增加似乎能预测未来的记忆衰退。