Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Neurobiol Aging. 2011 Oct;32(10):1733-41. doi: 10.1016/j.neurobiolaging.2009.11.008. Epub 2009 Dec 11.
The identification of biological markers at early stages of Alzheimer's disease (AD) contributes to diagnostic accuracy and adds prognostic value. However, in spite of recent developments, results of neurostructural imaging studies on predicting conversion to AD are not uniform. We conducted a systematic review of voxel-based morphometry (VBM) studies about the neurostructural predictors of conversion to AD. Ten studies met inclusion criteria and nine reported baseline regional gray matter (GM) atrophy in mild cognitive impairment (MCI) or healthy subjects who progressed to AD. Using the method of Activation Likelihood Estimation, we meta-analyzed the coordinates from the six longitudinal VBM studies that enrolled subjects with amnestic MCI (aMCI) at baseline. These comprised a total of 429 aMCI subjects, of which 142 converted to AD. Meta-analysis yielded one significant cluster of GM volumetric reduction in aMCI patients who converted to AD, located in the left hippocampus and parahippocampal gyrus. In conclusion, left medial temporal lobe atrophy is the most consistent neurostructural biomarker to predict conversion from aMCI to AD.
在阿尔茨海默病（AD）的早期阶段识别生物标志物有助于提高诊断准确性并增加预后价值。然而，尽管最近取得了一些进展，但神经结构影像学研究在预测向 AD 转化方面的结果并不一致。我们对基于体素的形态测量学（VBM）研究进行了系统评价，这些研究探讨了神经结构预测 AD 转化的因素。符合纳入标准的有 10 项研究，其中 9 项报告了轻度认知障碍（MCI）或健康受试者的基线区域灰质（GM）萎缩，这些受试者进展为 AD。我们使用激活似然估计法对纳入基线遗忘型 MCI（aMCI）受试者的 6 项纵向 VBM 研究的坐标进行了荟萃分析。这些研究共纳入了 429 名 aMCI 患者，其中 142 名患者转化为 AD。荟萃分析显示，转化为 AD 的 aMCI 患者的左侧海马和海马旁回 GM 体积减少存在一个显著的簇。总之，左侧内侧颞叶萎缩是预测从 aMCI 向 AD 转化的最一致的神经结构生物标志物。
