Division of Geriatric Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, NY, USA.
Neuroimage. 2012 Apr 15;60(3):1622-9. doi: 10.1016/j.neuroimage.2012.01.075. Epub 2012 Jan 25.
Using MRI surface morphometry mapping, to evaluate local deformations of the hippocampus, parahippocampal gyrus, and entorhinal cortex in predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD).
Baseline brain MRI with surface morphological analysis was performed in 130 outpatients with MCI, broadly defined, and 61 healthy controls followed for an average of 4 years in a single site study.
Patients with MCI differed from controls in several regions of the hippocampus and entorhinal cortex, and to a lesser extent in the parahippocampal gyrus. In the MCI sample, Cox regression models were conducted for time to conversion comparing converters to AD (n=31) and non-converters (n=99), controlling for age, sex and education. Converters showed greater atrophy in the head of the hippocampus, predominantly in the CA1 region and subiculum, and in the entorhinal cortex, especially in the anterior-inferior pole bilaterally. When distances of specific points representing localized inward deformation were entered together with the corresponding hippocampal or entorhinal cortex volume in the same Cox regression model, the distances remained highly significant whereas the volumes of the corresponding structures were either marginally significant or not significant. Inclusion of cognitive or memory measures or apolipoprotein E ε4 genotype as covariates, or restricting the sample to patients with amnestic MCI (24 converters and 81 non-converters) did not materially change the findings. In the 3-year follow-up sample of patients with MCI, logistic regression analyses using the same measures and covariates yielded similar results.
These findings indicate selective early involvement of the CA1 and subiculum regions of the hippocampus and provide new information on early anterior pole involvement in the entorhinal cortex in incipient AD. Fine-grained surface morphometry of medial temporal lobe structures may be superior to volumetric assessment in predicting conversion to AD in patients clinically diagnosed with MCI.
使用 MRI 表面形态测量图，评估内侧颞叶结构（海马体、海马旁回和内嗅皮层）的局部变形，以预测从轻度认知障碍（MCI）到阿尔茨海默病（AD）的转化。
在一个单一的研究地点，对 130 名广义定义的 MCI 门诊患者和 61 名健康对照者进行了基线脑 MRI 表面形态分析，平均随访时间为 4 年。
MCI 患者与对照组在海马体和内嗅皮层的几个区域存在差异，在海马旁回的差异较小。在 MCI 样本中，对时间到转换的 Cox 回归模型进行了比较，将转化为 AD（n=31）和非转化（n=99）的患者进行比较，控制了年龄、性别和教育。与非转化者相比，转化者的海马体头部，特别是 CA1 区和下托，以及内嗅皮层，特别是双侧前下极，出现了更大的萎缩。当代表局部向内变形的特定点的距离与同一 Cox 回归模型中的相应海马体或内嗅皮层体积一起输入时，距离仍然具有高度显著性，而相应结构的体积则是边缘显著或不显著。将认知或记忆测量或载脂蛋白 E ε4 基因型作为协变量纳入，或将样本限制为遗忘型 MCI 患者（24 名转化者和 81 名非转化者），并不会改变这些发现。在 MCI 患者的 3 年随访样本中，使用相同的测量和协变量进行的逻辑回归分析得出了类似的结果。
这些发现表明海马体 CA1 和下托区域的选择性早期受累，并提供了关于早期 AD 中内嗅皮层前极受累的新信息。内侧颞叶结构的精细表面形态测量可能优于体积评估，在预测临床上诊断为 MCI 的患者向 AD 的转化方面具有优势。
