School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
Neurosci Biobehav Rev. 2012 Jan;36(1):297-309. doi: 10.1016/j.neubiorev.2011.06.009. Epub 2011 Jun 30.
Atrophy of the medial temporal lobe, especially the hippocampus and the parahippocampal gyrus, is considered to be the most predictive structural brain biomarker for Alzheimer's Dementia (AD). However, recent neuroimaging studies reported a possible mismatch between structural and metabolic findings, showing medial temporal lobe atrophy and medial parietal hypoperfusion as biomarkers for AD. The role of the parietal lobe in the development of AD is only recently beginning to attract attention. The current review discusses parietal lobe involvement in the early stages of AD, viz. mild cognitive impairment, as reported from structural, functional, perfusion and metabolic neuroimaging studies. The medial and posterior parts of the parietal lobe seem to be preferentially affected, compared to the other parietal lobe parts. On the basis of the reviewed literature we propose a model showing the relationship between the various pathological events, as measured by different neuroimaging techniques, in the development of AD. In this model myelin breakdown is a beginning of the chain of pathological events leading to AD pathology and an AD diagnosis.
内侧颞叶，尤其是海马和海马旁回的萎缩被认为是最具预测性的阿尔茨海默病（AD）的结构脑生物标志物。然而，最近的神经影像学研究报告了结构和代谢发现之间可能存在不匹配，表明内侧颞叶萎缩和内侧顶叶灌注不足是 AD 的生物标志物。顶叶在 AD 发展中的作用直到最近才开始引起关注。目前的综述讨论了顶叶在 AD 的早期阶段（即轻度认知障碍）中的作用，这是从结构、功能、灌注和代谢神经影像学研究中报告的。与其他顶叶部分相比，内侧和后部顶叶似乎更容易受到影响。基于已审查的文献，我们提出了一个模型，显示了不同神经影像学技术测量的各种病理事件在 AD 发展过程中的关系。在该模型中，髓鞘破坏是导致 AD 病理和 AD 诊断的一系列病理事件的开始。
