Tapiola Tero, Pennanen Corina, Tapiola Mia, Tervo Susanna, Kivipelto Miia, Hänninen Tuomo, Pihlajamäki Maija, Laakso Mikko P, Hallikainen Merja, Hämäläinen Anne, Vanhanen Matti, Helkala Eeva-Liisa, Vanninen Ritva, Nissinen Aulikki, Rossi Roberta, Frisoni Giovanni B, Soininen Hilkka
Department of Neuroscience and Neurology, University of Kuopio, Brain Research Unit, Clinical Research Center, Mediteknia, 70211 Kuopio, Finland.
Neurobiol Aging. 2008 Jan;29(1):31-8. doi: 10.1016/j.neurobiolaging.2006.09.007. Epub 2006 Nov 13.
The concept of mild cognitive impairment (MCI) has been proposed to represent a transitional stage between normal aging and dementia. We studied the predictive value of the MRI-derived volumes of medial temporal lobe (MTL) structures, white matter lesions (WML), neuropsychological tests, and Apolipoprotein E (APOE) genotype on conversion of MCI to dementia and AD. The study included 60 subjects with MCI identified from population cohorts. During the mean follow-up period of 34 months, 13 patients had progressed to dementia (9 to Alzheimer's disease (AD)). In Cox regression analysis the baseline volumes of the right hippocampus, the right entorhinal cortex and CDR sum of boxes predicted the progression of MCI to dementia during the follow-up. In a bivariate analysis, only the baseline volumes of entorhinal cortex predicted conversion of MCI to AD. The Mini-Mental State Examination (MMSE) score at baseline, WML load, or APOE genotype were not significant predictors of progression. The MTL volumetry helps in identifying among the MCI subjects a group, which is at high risk for developing AD.
轻度认知障碍（MCI）的概念已被提出，用以代表正常衰老与痴呆之间的过渡阶段。我们研究了磁共振成像（MRI）得出的内侧颞叶（MTL）结构体积、白质病变（WML）、神经心理学测试以及载脂蛋白E（APOE）基因型对MCI转化为痴呆和阿尔茨海默病（AD）的预测价值。该研究纳入了60名从人群队列中识别出的MCI患者。在平均34个月的随访期内，13名患者进展为痴呆（9名发展为阿尔茨海默病（AD））。在Cox回归分析中，右侧海马体、右侧内嗅皮质的基线体积以及CDR框总和预测了随访期间MCI向痴呆的进展。在双变量分析中，只有内嗅皮质的基线体积预测了MCI向AD的转化。基线时的简易精神状态检查表（MMSE）评分、WML负荷或APOE基因型并非进展的显著预测指标。MTL体积测定有助于在MCI患者中识别出一组有患AD高风险的人群。
