社区人群主观记忆缺陷的神经影像学关联
Neuroimaging correlates of subjective memory deficits in a community population.
作者信息
Stewart R, Dufouil C, Godin O, Ritchie K, Maillard P, Delcroix N, Crivello F, Mazoyer B, Tzourio C
机构信息
King's College London, Institute of Psychiatry, London, UK.
出版信息
Neurology. 2008 Apr 29;70(18):1601-7. doi: 10.1212/01.wnl.0000310982.99438.54.
BACKGROUND
Subjective memory deficit (SMD) is one of few potential presenting symptoms for people with early cognitive impairment. However, associations with underlying brain changes are unclear.
METHODS
In a community sample of 1,779 people without dementia, and with neuroimaging (MRI) data, associations were investigated for SMD with white matter lesion volume and with the following volumetric measures: gray and white matter, CSF, hippocampal, parahippocampal, and amygdalar. Covariates included depressive symptoms (Center for Epidemiologic Studies Depression Scale), a battery of cognitive tests, physical health, and social activity.
RESULTS
SMD was present in 26.4% of the sample. Of the neuroimaging measures analyzed, SMD was most strongly associated with temporal WML (OR for highest quintile compared to the remainder 1.44, 95% CI 1.12-1.85), and lower hippocampal volume (OR per decreasing quintile 1.22, 1.11-1.35). These associations were independent of all other covariates, including cognitive function.
CONCLUSIONS
Subjective memory deficit (SMD) was associated with neuroimaging characteristics in the temporal and hippocampal regions, suggesting that SMD may, at least in some cases, represent a realistic appraisal of underlying brain function independent of measured cognition. However, further research is required for volumetric measures and SMD to establish whether the association reflects lifelong structure or neurodegenerative changes.
背景
主观记忆缺陷(SMD)是早期认知障碍患者少数可能出现的症状之一。然而,其与潜在脑改变之间的关联尚不清楚。
方法
在一个包含1779名无痴呆症且有神经影像学(MRI)数据的社区样本中,研究了SMD与白质病变体积以及以下体积测量指标之间的关联:灰质和白质、脑脊液、海马体、海马旁回和杏仁核。协变量包括抑郁症状(流行病学研究中心抑郁量表)、一系列认知测试、身体健康状况和社交活动。
结果
样本中26.4%的人存在SMD。在所分析的神经影像学测量指标中,SMD与颞叶白质病变(最高五分位数与其余部分相比的比值比为1.44,95%置信区间为1.12 - 1.85)以及海马体体积减小(每降低一个五分位数的比值比为1.22,1.11 - 1.35)的关联最为强烈。这些关联独立于所有其他协变量,包括认知功能。
结论
主观记忆缺陷(SMD)与颞叶和海马体区域的神经影像学特征相关,这表明SMD至少在某些情况下可能代表对潜在脑功能的现实评估,而与测量的认知无关。然而,对于体积测量指标和SMD,还需要进一步研究以确定这种关联是否反映终身结构或神经退行性变化。