Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
Alzheimer Dis Assoc Disord. 2009 Jul-Sep;23(3):245-52. doi: 10.1097/WAD.0b013e318199ff46.
Although early studies on mild cognitive impairment (MCI) focused on memory dysfunction; more recent studies suggest that MCI is clinically heterogeneous. The objective of this study is to examine patterns of cerebral perfusion in anmestic (N=12) and nonamnestic (N=12) single-domain MCI patients from 4 a priori regions of interest: middle and superior frontal cortex, posterior cingulate, and precuneus, to compare them relative to healthy controls (N=12), and to correlate perfusion with neuropsychologic measures. Relative to controls, all MCI patients had hypoperfusion in the posterior cingulate, bilaterally. MCI patients with executive dysfunctions also showed hypoperfusion in bilateral middle frontal cortex and the left precuneus relative to controls and in the left middle frontal cortex, left posterior cingulate, and left precuneus relative to amnestic MCI patients. Perfusion in the posterior cingulate correlated positively with memory performance whereas perfusion in all 4 a priori regions of interest, predominantly on the left side, correlated with executive function performance. The finding that single-domain MCI patients with prominent deficits in different cognitive domains exhibited different patterns of hypoperfusion relative to controls supports the existence of distinct subgroups of MCI. These data further suggest that cognitive impairment in MCI is related to cerebral hypoperfusion.
尽管早期有关轻度认知障碍 (MCI) 的研究主要集中在记忆功能障碍上;但最近的研究表明,MCI 在临床上存在异质性。本研究的目的是检查遗忘型 (N=12) 和非遗忘型 (N=12) 单领域 MCI 患者在 4 个预先设定的感兴趣区域(中额和上额皮层、后扣带回和楔前叶)的脑灌注模式,将其与健康对照组(N=12)进行比较,并将灌注与神经心理学测量相关联。与对照组相比,所有 MCI 患者在后扣带回均表现出双侧灌注不足。执行功能障碍的 MCI 患者与对照组相比,双侧额中回和左侧楔前叶也表现出灌注不足,与遗忘型 MCI 患者相比,左侧额中回、左后扣带回和左楔前叶也表现出灌注不足。后扣带回的灌注与记忆表现呈正相关,而 4 个预先设定的感兴趣区域的灌注(主要在左侧)与执行功能表现呈正相关。在不同认知领域有明显缺陷的单领域 MCI 患者与对照组相比表现出不同的灌注不足模式,这一发现支持 MCI 存在不同亚组的存在。这些数据进一步表明,MCI 中的认知障碍与脑灌注不足有关。