Burns A, Jacoby R, Levy R
Section of Old Age Psychiatry, Institute of Psychiatry, London, England.
Biol Psychiatry. 1991 Feb 15;29(4):383-90. doi: 10.1016/0006-3223(91)90224-a.
Sixty-three patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease (AD) received neuropsychological tests and computed tomography (CT) scans 12 months apart. Significant deterioration occurred in all the cognitive tests and in the CT measures used, that is, lateral ventricular size, third ventricular size, and cortical atrophy. There was a wide variation in the size of the changes taking place; 14 of 63 patients showed no significant change and 6 showed a marked increase in ventricular size. However, neither group differed from the others in any demographic, cognitive, or other CT variables which suggested, on the CT measures used, that no clearly identifiable subgroups of AD were present. Change in CT indices was not related to initial severity of disease. An increase in ventricular size was related to deterioration of cognitive function. These results require further replication. The methodological drawbacks of such studies are discussed.
63名符合阿尔茨海默病(AD)NINCDS/ADRDA标准的患者接受了神经心理学测试和计算机断层扫描(CT),两次检查间隔12个月。所有认知测试以及所采用的CT测量指标,即侧脑室大小、第三脑室大小和皮质萎缩,均出现了显著恶化。所发生变化的程度差异很大;63名患者中有14名未出现显著变化,6名患者的脑室大小显著增加。然而,在任何人口统计学、认知或其他CT变量方面,这两组与其他组均无差异,这表明在所采用的CT测量指标上,不存在可明确识别的AD亚组。CT指标的变化与疾病的初始严重程度无关。脑室大小的增加与认知功能的恶化有关。这些结果需要进一步验证。本文讨论了此类研究在方法上的缺陷。