Whitwell J L, Shiung M M, Przybelski S A, Weigand S D, Knopman D S, Boeve B F, Petersen R C, Jack C R
Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
Neurology. 2008 Feb 12;70(7):512-20. doi: 10.1212/01.wnl.0000280575.77437.a2. Epub 2007 Sep 26.
To compare the patterns of gray matter loss in subjects with amnestic mild cognitive impairment (aMCI) who progress to Alzheimer disease (AD) within a fixed clinical follow-up time vs those who remain stable.
Twenty-one subjects with aMCI were identified from the Mayo Clinic Alzheimer's research program who remained clinically stable for their entire observed clinical course (aMCI-S), where the minimum required follow-up time from MRI to last follow-up assessment was 3 years. These subjects were age- and gender-matched to 42 aMCI subjects who progressed to AD within 18 months of the MRI (aMCI-P). Each subject was then age- and gender-matched to a control subject. Voxel-based morphometry (VBM) was used to assess patterns of gray matter atrophy in the aMCI-P and aMCI-S groups compared to the control group, and compared to each other.
The aMCI-P group showed bilateral loss affecting the medial and inferior temporal lobe, temporoparietal association neocortex, and frontal lobes, compared to controls. The aMCI-S group showed no regions of gray matter loss when compared to controls. When the aMCI-P and aMCI-S groups were compared directly, the aMCI-P group showed greater loss in the medial and inferior temporal lobes, the temporoparietal neocortex, posterior cingulate, precuneus, anterior cingulate, and frontal lobes than the aMCI-S group.
The regions of loss observed in subjects with amnestic mild cognitive impairment (aMCI) who progressed to Alzheimer disease (AD) within 18 months of the MRI are typical of subjects with AD. The lack of gray matter loss in subjects with aMCI who remained clinically stable for their entire observed clinical course is consistent with the notion that patterns of atrophy on MRI at baseline map well onto the subsequent clinical course.
比较在固定临床随访时间内进展为阿尔茨海默病（AD）的遗忘型轻度认知障碍（aMCI）患者与病情保持稳定的患者的灰质丢失模式。
从梅奥诊所阿尔茨海默病研究项目中确定了21名aMCI患者，他们在整个观察到的临床过程中临床症状保持稳定（aMCI-S），从MRI检查到最后一次随访评估的最短随访时间为3年。这些患者在年龄和性别上与42名在MRI检查后18个月内进展为AD的aMCI患者（aMCI-P）相匹配。然后，将每名患者在年龄和性别上与一名对照受试者相匹配。采用基于体素的形态学测量（VBM）方法，评估aMCI-P组和aMCI-S组相对于对照组以及两组之间的灰质萎缩模式。
与对照组相比，aMCI-P组表现出双侧灰质丢失，累及内侧和颞下回、颞顶联合新皮质以及额叶。与对照组相比，aMCI-S组未显示出灰质丢失区域。直接比较aMCI-P组和aMCI-S组时，aMCI-P组在内侧和颞下回、颞顶新皮质、后扣带回、楔前叶、前扣带回和额叶的灰质丢失比aMCI-S组更严重。
在MRI检查后18个月内进展为阿尔茨海默病（AD）的遗忘型轻度认知障碍（aMCI）患者中观察到的灰质丢失区域是AD患者的典型表现。在整个观察到的临床过程中临床症状保持稳定的aMCI患者未出现灰质丢失，这与基线时MRI上的萎缩模式能很好地反映后续临床过程的观点一致。
