Frisoni Giovanni B, Prestia Annapaola, Rasser Paul E, Bonetti Matteo, Thompson Paul M
Laboratory of Epidemiology Neuroimaging and Telemedicine, IRCCS Centro San Giovanni di Dio FBF, The National Centre for Research and Care of Alzheimer's and Mental Diseases, via Pilastroni 4, 25125, Brescia, Italy.
J Neurol. 2009 Jun;256(6):916-24. doi: 10.1007/s00415-009-5040-7. Epub 2009 Feb 28.
Progressive brain atrophy is believed to be the Alzheimer's disease (AD) marker with the greatest evidence for validity. Mapping the topography of cortical atrophy throughout the stages of severity may allow the neural networks affected to be identified. Twenty healthy elderly persons (OH, MMSE 29.1 +/- 1.0), 11 patients with incipient AD (iAD, 26.5 +/- 2.0), 15 with mild AD (miAD, 23.5 +/- 2.2), and 15 with moderate AD (moAD, 16.5 +/- 2.0) underwent 3D magnetic resonance. Cortical pattern matching analysis was performed and maps of percent differences in gray matter distribution were computed between the following groups: iAD versus OH, miAD versus iAD, and moAD versus miAD. Compared to OH, iAD patients exhibited a mean cortical gray matter loss of 9-20% in areas encompassing the polysynaptic hippocampal pathway (posterior cingulate/retrosplenial and medial temporal cortex) and subgenual/orbitofrontal cortices, and a less widespread loss of 5-11% in other neocortical areas. Compared to iAD, miAD featured widespread mean gray matter loss of 14-19% in areas encompassing the direct hippocampal pathway (temporal pole, temporoparietal association cortex, and dorsal prefrontal cortex), sensorimotor, and visual cortex, with a less marked loss (7-9%) in the polysynaptic pathway areas. Compared to miAD, only atrophy in the primary sensorimotor cortex was still relatively marked in moAD, with a mean gray matter loss of 10-11%; the loss in other regions was generally below 10%. These findings suggest that the polysynaptic hippocampal pathway is affected in iAD, the direct pathway and sensorimotor and visual networks are affected in moAD, and the sensorimotor network is affected in moAD.
进行性脑萎缩被认为是阿尔茨海默病（AD）最具有效性证据的标志物。描绘整个严重程度阶段的皮质萎缩地形图可能有助于识别受影响的神经网络。20名健康老年人（OH，简易精神状态检查表[MMSE]评分为29.1±1.0）、11名早期AD患者（iAD，26.5±2.0）、15名轻度AD患者（miAD，23.5±2.2）和15名中度AD患者（moAD，16.5±2.0）接受了三维磁共振成像检查。进行了皮质模式匹配分析，并计算了以下几组之间灰质分布百分比差异的图谱：iAD与OH、miAD与iAD、moAD与miAD。与OH相比，iAD患者在包括多突触海马通路（后扣带回/压后皮质和内侧颞叶皮质）以及膝下/眶额皮质的区域，平均皮质灰质损失为9%至20%，在其他新皮质区域则有较广泛但程度较轻的5%至11%的损失。与iAD相比，miAD的特征是在包括直接海马通路（颞极、颞顶联合皮质和背侧前额叶皮质）、感觉运动和视觉皮质的区域，平均灰质广泛损失14%至19%，在多突触通路区域的损失则不太明显（7%至9%）。与miAD相比，仅初级感觉运动皮质的萎缩在moAD中仍相对明显，平均灰质损失为10%至11%；其他区域的损失一般低于10%。这些发现表明，多突触海马通路在iAD中受到影响，直接通路以及感觉运动和视觉网络在miAD中受到影响，而感觉运动网络在moAD中受到影响。
