LENITEM Laboratory of Epidemiology, Neuroimaging, and Telemedicine - IRCCS Centro San Giovanni di Dio-FBF, Brescia, Italy.
J Alzheimers Dis. 2012;31(3):623-33. doi: 10.3233/JAD-2012-111817.
Brain reserve allows some people to be more resilient to neurodegeneration processes and brain diseases. Structural markers of brain reserve are hippocampus, lateral ventricles, and white matter lesions volume (HV, LVV, WMLV). Subjects in the low end of the distribution of these markers are at higher risk to develop brain diseases such as Alzheimer's disease. We described the distribution of the above markers in a large group of cognitively-intact persons. A sample of 158 people aged between 40 to 90 years (mean ± SD: 60 ± 12 years, education 9 ± 4 years, MMSE score 28 ± 2) belonging to the Italian Brain Normative Archive was selected. HV, LVV, and WMLV were measured with validated procedures. The HV and LVV were measured by manual segmentation and the Freesurfer software, respectively, and normalized by head size; WMLV was measured with semi-automated thresholding. Test-retest reliability was >0.83 for all measures. No relationship was found between HV and age, whereas a significant relationship was found for LVV and WMLV (ventricle left: B 0.02, 95% CI 0.22 to 0.34; ventricle right: B 0.02 95% CI 0.23 to 0.34 p < 0.001; WML: B 0.04; 95% CI 0.03 to 0.06 p < 0.005). The 5th percentile threshold indicating lower brain reserve were: (i) HV below 2,260 mm(3) at 40 and 2,000 mm(3) at 90; (ii) LVV above 17,000 mm(3) at 40 and 60,000 mm(3) at 90; and (iii) WMLV above 1,200 mm(3) at 40 and 8,700 mm(3) at 90. Normative data of brain reserve markers can be used to estimate the brain resilience to neurodegeneration.
脑储备使一些人能够更好地抵抗神经退行性变过程和脑部疾病。脑储备的结构标志物包括海马体、侧脑室和白质病变体积（HV、LVV、WMLV）。这些标志物分布处于低水平的受试者，患阿尔茨海默病等脑部疾病的风险更高。我们描述了一大群认知正常人群中这些标志物的分布情况。选择了意大利大脑正常档案中的 158 名年龄在 40 至 90 岁之间的参与者（平均 ± 标准差：60 ± 12 岁，教育程度 9 ± 4 年，MMSE 评分 28 ± 2）。HV、LVV 和 WMLV 采用经过验证的程序进行测量。HV 和 LVV 通过手动分割测量，Freesurfer 软件分别进行测量，并通过头部大小进行归一化；WMLV 通过半自动阈值测量。所有指标的测试-重测信度均>0.83。HV 与年龄之间无相关性，而 LVV 和 WMLV 之间存在显著相关性（左脑室：B 0.02，95%CI 0.22 至 0.34；右脑室：B 0.02，95%CI 0.23 至 0.34，p<0.001；WML：B 0.04；95%CI 0.03 至 0.06，p<0.005）。表示脑储备较低的第 5 百分位阈值为：（i）40 岁时 HV 低于 2,260mm³，90 岁时 HV 低于 2,000mm³；（ii）40 岁时 LVV 高于 17,000mm³，90 岁时 LVV 高于 60,000mm³；（iii）40 岁时 WMLV 高于 1,200mm³，90 岁时 WMLV 高于 8,700mm³。脑储备标志物的正常数据可用于估计脑对神经退行性变的适应能力。
