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使用基于体素的形态计量学评估从轻度认知障碍(MCI)到阿尔茨海默病(AD)以及正常衰老过程中海马萎缩进展的三维表面映射。

Three-dimensional surface mapping of hippocampal atrophy progression from MCI to AD and over normal aging as assessed using voxel-based morphometry.

作者信息

Chételat G, Fouquet M, Kalpouzos G, Denghien I, De la Sayette V, Viader F, Mézenge F, Landeau B, Baron J C, Eustache F, Desgranges B

机构信息

Inserm-EPHE-Université de Caen Basse-Normandie, Unité U923, GIP Cyceron, CHU Côte de Nacre, Caen, France.

出版信息

Neuropsychologia. 2008;46(6):1721-31. doi: 10.1016/j.neuropsychologia.2007.11.037. Epub 2008 Jan 16.

Abstract

The hippocampus is the brain structure of highest and earliest structural alteration in Alzheimer's disease (AD). New developments in neuroimaging methods recently made it possible to assess the respective involvement of the different hippocampal subfields by mapping atrophy on a 3D hippocampal surface view. In this longitudinal study on patients with mild cognitive impairment (MCI), we used such an approach to map the profile of hippocampal atrophy and its progression over an 18-month follow-up period in rapid converters to AD and "non-converters" compared to age-matched controls. For the sake of comparison, we also assessed the profile of hippocampal atrophy associated with AD and with increasing age in a healthy control population ranging from young adult to elderly. We found major involvement of the lateral part of the superior hippocampus mainly corresponding to the CA1 subfield in MCI and AD while increasing age was mainly associated with subiculum atrophy in the healthy population. Moreover, the CA1 subfield also showed highest atrophy rates during follow-up, in both rapid converters and "non-converters" although increased effects were observed in the former group. This study emphasizes the differences between normal aging and AD processes leading to hippocampal atrophy, pointing to a specific AD-related CA1 involvement while subiculum atrophy would represent a normal aging process. Our findings also suggest that the degree of hippocampal atrophy, more than its spatial localization, predicts rapid conversion to AD in patients with MCI.

摘要

海马体是阿尔茨海默病(AD)中最早出现结构改变且结构改变最为显著的脑区。神经成像方法的新进展使得通过在三维海马体表视图上绘制萎缩情况来评估不同海马亚区各自的受累情况成为可能。在这项针对轻度认知障碍(MCI)患者的纵向研究中,我们采用这种方法绘制了海马萎缩的情况及其在18个月随访期内的进展,将快速进展为AD的患者和“未进展者”与年龄匹配的对照组进行比较。为了进行比较,我们还评估了在从年轻成年人到老年人的健康对照人群中与AD及年龄增长相关的海马萎缩情况。我们发现,在MCI和AD中,主要受累的是海马体上部的外侧部分,主要对应于CA1亚区,而在健康人群中,年龄增长主要与下托萎缩相关。此外,在随访期间,CA1亚区在快速进展者和“未进展者”中均显示出最高的萎缩率,尽管在前一组中观察到了更大的影响。这项研究强调了正常衰老和导致海马萎缩的AD过程之间的差异,指出了与AD相关的特定CA1受累情况,而下托萎缩则代表正常衰老过程。我们的研究结果还表明,在MCI患者中,海马萎缩的程度比其空间定位更能预测快速进展为AD。

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