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轻度认知障碍和轻度阿尔茨海默病中的三维灰质萎缩图谱

Three-dimensional gray matter atrophy mapping in mild cognitive impairment and mild Alzheimer disease.

作者信息

Apostolova Liana G, Steiner Calen A, Akopyan Gohar G, Dutton Rebecca A, Hayashi Kiralee M, Toga Arthur W, Cummings Jeffrey L, Thompson Paul M

机构信息

Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, 10911 Westwood Blvd, Second Floor, Los Angeles, CA 90095, USA.

出版信息

Arch Neurol. 2007 Oct;64(10):1489-95. doi: 10.1001/archneur.64.10.1489.

Abstract

BACKGROUND

Alzheimer disease (AD) is the most common form of dementia worldwide. Mild cognitive impairment (MCI) is the recent terminology for patients with cognitive deficiencies in the absence of functional decline. Most patients with MCI harbor the pathologic changes of AD and demonstrate transition to dementia at a rate of 10% to 15% per year. Patients with AD and MCI experience progressive brain atrophy.

OBJECTIVE

To analyze the structural magnetic resonance imaging data for 24 patients with amnestic MCI and 25 patients with mild AD using an advanced 3-dimensional cortical mapping technique.

DESIGN

Cross-sectional cohort design. Patients/

METHODS

We analyzed the structural magnetic resonance imaging data of 24 amnestic MCI (mean MMSE, 28.1; SD, 1.7) and 25 mild AD patients (all MMSE scores, >18; mean MMSE, 23.7; SD, 2.9) using an advanced 3-dimensional cortical mapping technique.

RESULTS

We observed significantly greater cortical atrophy in patients with mild AD. The entorhinal cortex, right more than left lateral temporal cortex, right parietal cortex, and bilateral precuneus showed 15% more atrophy and the remainder of the cortex primarily exhibited 10% to 15% more atrophy in patients with mild AD than in patients with amnestic MCI.

CONCLUSION

There are striking cortical differences between mild AD and the immediately preceding cognitive state of amnestic MCI. Cortical areas affected earlier in the disease process are more severely affected than those that are affected late. Our method may prove to be a reliable in vivo disease-tracking technique that can also be used for evaluating disease-modifying therapies in the future.

摘要

背景

阿尔茨海默病(AD)是全球最常见的痴呆形式。轻度认知障碍(MCI)是近期用于描述存在认知缺陷但无功能衰退患者的术语。大多数MCI患者存在AD的病理改变,且每年有10%至15%的患者会转变为痴呆。AD和MCI患者会出现进行性脑萎缩。

目的

使用先进的三维皮质映射技术分析24例遗忘型MCI患者和25例轻度AD患者的结构磁共振成像数据。

设计

横断面队列设计。患者/

方法

我们使用先进的三维皮质映射技术分析了24例遗忘型MCI患者(平均MMSE,28.1;标准差,1.7)和25例轻度AD患者(所有MMSE评分>18;平均MMSE,23.7;标准差,2.9)的结构磁共振成像数据。

结果

我们观察到轻度AD患者的皮质萎缩明显更严重。与遗忘型MCI患者相比,轻度AD患者的内嗅皮质、右侧多于左侧的颞叶外侧皮质、右侧顶叶皮质以及双侧楔前叶萎缩多出15%,其余皮质主要萎缩多出10%至15%。

结论

轻度AD与紧接其前的遗忘型MCI认知状态之间存在明显的皮质差异。疾病过程中早期受影响的皮质区域比晚期受影响的区域受影响更严重。我们的方法可能被证明是一种可靠的体内疾病追踪技术,未来也可用于评估疾病修饰疗法。

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