Division Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland.
J Alzheimers Dis. 2011;26(4):719-34. doi: 10.3233/JAD-2011-101260.
Distinguishing amnestic mild cognitive impairment (MCI) from Alzheimer's disease (AD) and healthy aging depends mainly on clinical evaluation, and, ultimately, on investigator's judgment. Clinical evaluation in vivo is based primarily on cognitive assessments. The present study explores the potential of volumetric magnetic resonance imaging of parietal and lateral temporal brain structures to support the diagnosis of AD and to distinguish AD patients from patients with MCI and healthy control subjects (HCS). 52 age-matched HCS, 18 patients with MCI, and 59 patients with probable late onset AD were investigated. Using computational, neuromorphometric procedures gray matter (GM) was automatically parcellated into 28 local regions of interest, the volumes of which were computed. The left hippocampus (sensitivity/specificity: 80.8-90.4%/55.6-86.4%) and the right hippocampus (73.1-90.4%/66.7-84.7%) provided highest diagnostic accuracy in separating all three diagnostic groups. Promising diagnostic values for distinguishing MCI from HCS were found for the left superior parietal gyrus (61.5%/55.6%) and left supramarginal gyrus (65.4%/66.7%), and for distinguishing subjects with MCI from AD patients for the right middle temporal gyrus (77.8%/79.7%), left inferior temporal gyrus (83.3%/72.9%), and right superior temporal gyrus (77.8%/71.2%). The left superior temporal pole (92.3%/84.7%), left parahippocampal gyrus (86.5%/81.4%), left Heschl's gyrus (86.5%/79.7%), and the right superior temporal pole (82.7%/78.0%) revealed most promising diagnostic values for distinguishing AD patients from HCS. Data revealed that lateral temporal and parietal GM volumes distinguish between HCS, MCI, and AD as accurate as hippocampal volumes do; hence, these volumes can be used in the diagnostic procedure. Results also suggest that cognitive functions associated with these brain regions, e.g., language and visuospatial abilities, may be tested more extensively to obtain additional information that might enhance the diagnostic accuracy further.
区分遗忘型轻度认知障碍(MCI)与阿尔茨海默病(AD)和健康衰老主要依赖于临床评估,最终依赖于研究者的判断。体内临床评估主要基于认知评估。本研究探索了顶叶和外侧颞叶脑结构的容积磁共振成像的潜力,以支持 AD 的诊断,并将 AD 患者与 MCI 患者和健康对照组(HCS)区分开来。研究了 52 名年龄匹配的 HCS、18 名 MCI 患者和 59 名可能患有晚发性 AD 的患者。使用计算、神经形态计量程序,将灰质(GM)自动分割成 28 个局部感兴趣区,并计算其体积。左侧海马(敏感性/特异性:80.8-90.4%/55.6-86.4%)和右侧海马(73.1-90.4%/66.7-84.7%)在区分所有三个诊断组方面提供了最高的诊断准确性。在区分 MCI 与 HCS 方面,左侧顶上回(61.5%/55.6%)和左侧缘上回(65.4%/66.7%)具有有前景的诊断价值,在区分 MCI 与 AD 患者方面,右侧颞中回(77.8%/79.7%)、左侧颞下回(83.3%/72.9%)和右侧颞上回(77.8%/71.2%)具有有前景的诊断价值。左侧颞上极(92.3%/84.7%)、左侧海马旁回(86.5%/81.4%)、左侧 Heschl 回(86.5%/79.7%)和右侧颞上极(82.7%/78.0%)在区分 AD 与 HCS 方面显示出最有前景的诊断价值。数据表明,外侧颞叶和顶叶 GM 体积与海马体积一样,可以准确地区分 HCS、MCI 和 AD;因此,这些体积可以用于诊断程序。结果还表明,与这些脑区相关的认知功能,例如语言和视空间能力,可以更广泛地测试,以获得可能进一步提高诊断准确性的附加信息。