Pfefferbaum A, Sullivan E V, Jernigan T L, Zipursky R B, Rosenbloom M J, Yesavage J A, Tinklenberg J R
Psychiatry Service, Palo Alto VA Medical Center, CA 94304.
Psychiatry Res. 1990 Dec;35(2):115-36. doi: 10.1016/0925-4927(90)90015-x.
Patients with presumptive Alzheimer's disease (AD) and healthy community volunteers received computed tomographic (CT) brain scans and cognitive tests. The CT scans were quantitatively analyzed with a semiautomated thresholding technique to derive volumetric measures of cerebrospinal fluid (CSF)-to-tissue ratios in six regions of interest (ROIs): lateral ventricles; vertex sulci, frontal sulci, Sylvian fissures, parieto-occipital sulci, and third ventricle. Regression analysis was performed on CT data from 85 older volunteers (ages 51-82) to generate age norms for each ROI. Within this group, tissue loss, as measured by the % CSF in each ROI, was highly correlated with age, although each ROI showed different rates of change over age. For all ROIs, the AD group had significantly more tissue loss than expected in normal aging. In addition, AD patients with a presenescent onset (before age 65) tended to have greater vertex sulcal and frontal sulcal tissue reduction than AD patients with a senescent onset (age 65 or after). When regional tissue reduction, corrected for age, was correlated with cognitive test scores, two sets of double dissociations emerged within the AD group: large CT z scores (i.e., decreased tissue and increased CSF) of frontal sulci, but not of the third ventricle, correlated with low Comprehension and Boston Naming Test scores, whereas large CT z scores of the third ventricle, but not of the frontal sulci, correlated with low scores on Digit Symbol and Picture Arrangement. These results suggest that heterogeneity of structural and functional integrity exists among patients with AD.
疑似阿尔茨海默病（AD）患者和健康社区志愿者接受了脑部计算机断层扫描（CT）和认知测试。使用半自动阈值技术对CT扫描进行定量分析，以得出六个感兴趣区域（ROI）中脑脊液（CSF）与组织比率的体积测量值：侧脑室；顶叶沟、额叶沟、外侧裂、顶枕沟和第三脑室。对85名老年志愿者（年龄51 - 82岁）的CT数据进行回归分析，以生成每个ROI的年龄标准。在该组中，每个ROI中以CSF百分比衡量的组织损失与年龄高度相关，尽管每个ROI随年龄变化的速率不同。对于所有ROI，AD组的组织损失明显高于正常衰老预期。此外，早发性（65岁之前）AD患者的顶叶沟和额叶沟组织减少往往比晚发性（65岁及以后）AD患者更大。当对年龄校正后的区域组织减少与认知测试分数相关联时，AD组内出现了两组双重分离：额叶沟的CT z值较大（即组织减少和CSF增加），但第三脑室没有，与低理解能力和波士顿命名测试分数相关；而第三脑室的CT z值较大，但额叶沟没有，与数字符号和图片排列测试的低分相关。这些结果表明，AD患者之间存在结构和功能完整性的异质性。
