Di Paola M, Macaluso E, Carlesimo G A, Tomaiuolo F, Worsley K J, Fadda L, Caltagirone C
IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
J Neurol. 2007 Jun;254(6):774-81. doi: 10.1007/s00415-006-0435-1. Epub 2007 Apr 3.
The aims of this study were to investigate the pattern of cortical atrophy and the relationships between memory performances and the brain regions in Alzheimer's Disease (AD). optimized voxel-based morphometry (VBM) was applied to the MRI brain images of 18 probable AD and 18 healthy subjects (HS). Patients performed verbal and visuo-spatial episodic and shortterm memory tests. Contrasting of AD group with HS, and anatomobehavioural correlations were carried out in order to identify regional atrophic changes and neuro-cognitive aspects in AD group. We found evidence of gray matter (GM) volume reduction in AD in the medial temporal, parietal and frontal areas bilaterally and in the left anterior thalamic nuclei. Performance on the episodic memory delayed recall tests co-varied with GM volume in the left entorhinal cortex. The pattern of cortical atrophy likely reflects the heterogeneous level of dementia severity in our AD group. The anatomical region affected in the left hemisphere indicates a sufferance at multiple levels of the Polysynaptic Hippocampal Pathway, which is involved in declarative memory. Findings on the entorhinal cortex and the delayed memory scores support the role of the entorhinal cortex in episodic memory. Damage to the entorhinal cortex, deafferenting the hippocampus from neocortical inputs, interferes with episodic memory consolidation in AD patients.
本研究的目的是调查阿尔茨海默病（AD）患者的皮质萎缩模式以及记忆表现与脑区之间的关系。将优化的基于体素的形态计量学（VBM）应用于18例可能患有AD的患者和18例健康受试者（HS）的脑部MRI图像。患者进行了言语和视觉空间情景及短期记忆测试。将AD组与HS组进行对比，并进行解剖行为相关性分析，以确定AD组的区域萎缩变化和神经认知方面。我们发现，AD患者双侧内侧颞叶、顶叶和额叶以及左侧丘脑前核的灰质（GM）体积减少。情景记忆延迟回忆测试的表现与左侧内嗅皮质的GM体积共同变化。皮质萎缩模式可能反映了我们AD组中痴呆严重程度的异质性水平。左半球受影响的解剖区域表明多突触海马通路的多个水平存在损伤，该通路参与陈述性记忆。内嗅皮质和延迟记忆分数的研究结果支持内嗅皮质在情景记忆中的作用。内嗅皮质受损，使海马体失去新皮质输入，干扰了AD患者的情景记忆巩固。
