Chua Terence C, Wen Wei, Slavin Melissa J, Sachdev Perminder S
Neuropsychiatric Institute, Euroa Centre, Prince of Wales Hospital, Randwick, NSW, Australia.
Curr Opin Neurol. 2008 Feb;21(1):83-92. doi: 10.1097/WCO.0b013e3282f4594b.
To provide a comprehensive review of diffusion tensor imaging in evaluating microstructural changes in the spectrum of cognitive decline from ageing to Alzheimer's disease, in particular focusing on mild cognitive impairment.
Mild cognitive impairment represents a transition phase between normal ageing and early Alzheimer's disease. Diffusion tensor imaging has emerged as a useful imaging modality that provides information about the structural integrity of tissue. In healthy ageing, diffusion tensor imaging abnormalities occur in the frontal regions, specifically the frontal white matter, anterior cingulum and the genu of the corpus callosum. Some studies report an anterior-posterior gradient change with greater abnormalities in the genu than the splenium of the corpus callosum and in the frontal than parietal white matter. In Alzheimer's disease, diffusion tensor imaging abnormalities are concentrated in the posterior regions: the parahippocampal gyrus, temporal white matter, splenium of corpus callosum and posterior cingulum. In mild cognitive impairment, changes seem to parallel those in Alzheimer's disease, with similar posterior regions showing abnormalities.
Due to the similarities in diffusion tensor imaging findings in both mild cognitive impairment and Alzheimer's disease, it is likely that diffusion tensor imaging has the potential to emerge as a useful clinical tool for early detection and monitoring of disease progression and treatment response in mild cognitive impairment/Alzheimer's disease patients.
全面回顾扩散张量成像在评估从衰老到阿尔茨海默病认知衰退谱系中的微观结构变化，尤其关注轻度认知障碍。
轻度认知障碍代表正常衰老与早期阿尔茨海默病之间的过渡阶段。扩散张量成像已成为一种有用的成像方式，可提供有关组织结构完整性的信息。在健康衰老过程中，扩散张量成像异常出现在额叶区域，特别是额叶白质、前扣带回和胼胝体膝部。一些研究报告了前后梯度变化，胼胝体膝部的异常比压部更明显，额叶白质的异常比顶叶白质更明显。在阿尔茨海默病中，扩散张量成像异常集中在后部区域：海马旁回、颞叶白质、胼胝体压部和后扣带回。在轻度认知障碍中，变化似乎与阿尔茨海默病相似，相似的后部区域出现异常。
由于轻度认知障碍和阿尔茨海默病在扩散张量成像结果上的相似性，扩散张量成像有可能成为一种有用的临床工具，用于早期检测和监测轻度认知障碍/阿尔茨海默病患者的疾病进展及治疗反应。
