Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Brazil.
Braz J Psychiatry. 2011 Jun;33(2):122-9. doi: 10.1590/s1516-44462011000200006.
The aim of this study was to examine the cerebellar volume of subjects at different stages of Alzheimer's disease and to investigate whether volume reductions in this structure are related to cognitive decline.
Ninety-six subjects from an epidemiological study were submitted to a magnetic resonance imaging scan and evaluated using the Mini-Mental State Examination and the Functional Activities Questionnaire. Subjects were divided into five groups according to the Clinical Dementia Rating scale. Twenty-six subjects from the original group who had no dementia diagnosis at baseline were re-evaluated for the onset of dementia after two years.
The volumes of the cerebellar hemispheres, posterior cerebellar lobe, vermis and temporal lobe were found to be reduced as a function of the severity of the disease. There were significant positive correlations between the volume of the temporal lobe and cerebellum and the language, attention, and total scores in the Mini-Mental State Examination and the Functional Activities Questionnaire. A logistic regression analysis demonstrated that reduced temporal lobe, posterior cerebellar lobe and vermal volume at baseline is a risk factor for the onset of dementia.
This is the first study demonstrating that reduced cerebellar volume is already apparent at the predementia stage. The results of this study support the involvement of the cerebellum in the progression of dementia. Whereas the cerebellum might not be directly associated with the origin of Alzheimer's disease, it may provide useful information related to its prognosis.
本研究旨在探讨阿尔茨海默病不同阶段患者小脑体积的变化,并探讨该结构体积的减少是否与认知能力下降有关。
96 名来自一项流行病学研究的受试者接受了磁共振成像扫描,并使用简易精神状态检查和功能活动问卷进行了评估。根据临床痴呆评定量表,受试者被分为五组。在基线时没有痴呆诊断的 26 名原始组受试者在两年后重新评估是否出现痴呆。
随着疾病严重程度的增加,小脑半球、后小脑叶、小脑蚓部和颞叶的体积均减小。颞叶和小脑体积与简易精神状态检查和功能活动问卷的语言、注意力和总分呈显著正相关。逻辑回归分析表明,基线时颞叶、后小脑叶和小脑蚓部体积减小是痴呆发生的危险因素。
这是第一项表明小脑体积在痴呆前阶段已经减少的研究。本研究结果支持小脑参与痴呆的进展。虽然小脑可能与阿尔茨海默病的起源没有直接关系,但它可能提供与预后相关的有用信息。