Mühlau M, Wohlschläger A M, Gaser C, Valet M, Weindl A, Nunnemann S, Peinemann A, Etgen T, Ilg R
Department of Neurology, Technische Universität München, Munich, Germany.
AJNR Am J Neuroradiol. 2009 Mar;30(3):539-43. doi: 10.3174/ajnr.A1390. Epub 2008 Dec 12.
Voxel-based morphometry (VBM) has proved a powerful method to detect subtle changes of gray matter (GM) at the group level but the role of VBM for the detection of GM changes in single subjects, especially in those with suspected neurodegenerative disorder, remains uncertain. Here, we performed single subject analyses in 22 patients in early stages of Huntington disease (HD), a neurodegenerative disorder with a well-known and characteristic pattern of GM loss.
We applied an ANCOVA with age and gender as covariates and corrected for multiple statistical tests by false discovery rate (P < 0.05). Each patient was compared to 133 healthy controls. The same procedure was applied to 22 of the controls matched for age and gender in a pair-wise manner.
Our analyses yielded biologically plausible results in HD patients in which GM decrease within the caudate nucleus could be identified in 15 of the 16 most affected patients while GM decrease was found in only 1 control subject. Lowering the size of the control group yielded comparable results with 99 and 66 control subjects whereas sensitivity decreased with 33 control subjects.
Our pilot study demonstrates a potential role of VBM for the detection of cerebral GM changes in single subjects with suspected neurodegenerative disorder.
基于体素的形态学测量(VBM)已被证明是一种在群体水平上检测灰质(GM)细微变化的强大方法,但VBM在检测个体尤其是疑似神经退行性疾病患者的GM变化中的作用仍不确定。在此,我们对22例亨廷顿病(HD)早期患者进行了个体分析,HD是一种具有众所周知的典型GM丢失模式的神经退行性疾病。
我们应用以年龄和性别作为协变量的协方差分析,并通过错误发现率校正多重统计检验(P < 0.05)。将每位患者与133名健康对照进行比较。以成对方式对22名年龄和性别匹配的对照应用相同程序。
我们的分析在HD患者中得出了生物学上合理的结果,其中16名受影响最严重的患者中有15名可识别出尾状核内GM减少,而仅在1名对照受试者中发现GM减少。减少对照组规模,采用99名和66名对照受试者时得出了类似结果,而采用33名对照受试者时敏感性降低。
我们的初步研究证明了VBM在检测疑似神经退行性疾病个体的脑GM变化中的潜在作用。