Wang Pei-Ning, Liu Hsiu-Chih, Lirng Jiing-Feng, Lin Ker-Neng, Wu Zin-An
Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Psychiatry Res. 2009 Mar 31;171(3):221-31. doi: 10.1016/j.pscychresns.2008.05.002. Epub 2009 Feb 13.
Studies suggest that smaller hippocampal volume predicts Alzheimer's disease (AD) in mild cognitive impairment (MCI). However, few studies have demonstrated decline rates in cognition and hippocampal volume in MCI subjects with stable clinical presentation. Furthermore, the effects of apolipoprotein E (ApoE) on the change rates of medial temporal structures and cognition in MCI are rarely investigated. Fifty-eight subjects with amnestic MCI and 20 normal aging elderly controls received annual neuropsychological and magnetic resonance imaging (MRI) assessments. Annual decline rates in neuropsychological test scores, hippocampal and amygdalar volumes were calculated. ApoE genotypes were examined. Nineteen (32.7%) MCI subjects converted to AD during an average 22.5-month follow-up period. The annual hippocampal atrophy rate was correlated with a decline in memory test scores. The presence of the ApoE varepsilon4 allele did not affect the change rates in neuropsychological test scores and medial temporal structures volume. Compared to subjects with stable MCI (MCI-S) and normal aging, progressive MCI (MCI-P) had the highest annual decline rates in cognition and hippocampal volume. Logistic regression analysis showed that higher annual decline rates in hippocampal volume and global cognitive test scores were associated with conversion to AD. Furthermore, although MCI-S subjects had little cognitive decline, their hippocampal atrophy rates were higher than those of normal aging controls. Therefore, accelerated hippocampal atrophy rates may be an early and important presentation in MCI subjects.
研究表明，较小的海马体体积可预测轻度认知障碍（MCI）患者患阿尔茨海默病（AD）的风险。然而，很少有研究证明临床表现稳定的MCI患者的认知和海马体体积下降率。此外，载脂蛋白E（ApoE）对MCI患者内侧颞叶结构和认知变化率的影响鲜有研究。58名遗忘型MCI患者和20名正常衰老老年人作为对照，接受了年度神经心理学和磁共振成像（MRI）评估。计算神经心理学测试分数、海马体和杏仁核体积的年度下降率。检测ApoE基因型。在平均22.5个月的随访期内，19名（32.7%）MCI患者转变为AD。海马体年萎缩率与记忆测试分数的下降相关。ApoE ε4等位基因的存在不影响神经心理学测试分数和内侧颞叶结构体积的变化率。与稳定型MCI（MCI-S）患者和正常衰老者相比，进展型MCI（MCI-P）患者在认知和海马体体积方面的年度下降率最高。逻辑回归分析表明，海马体体积和整体认知测试分数的较高年度下降率与转变为AD相关。此外，尽管MCI-S患者几乎没有认知下降，但其海马体萎缩率高于正常衰老对照组。因此，海马体萎缩率加快可能是MCI患者的一种早期且重要的表现。
