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磁共振成像测量与早发性和晚发性阿尔茨海默病神经认知障碍的相关性。

Associations between magnetic resonance imaging measures and neuropsychological impairment in early and late onset alzheimer's disease.

机构信息

Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

J Alzheimers Dis. 2013;35(1):169-78. doi: 10.3233/JAD-121291.

DOI:10.3233/JAD-121291
PMID:23364136
Abstract

AIM

To assess the associations of global atrophy and white matter hyperintensities (WMH) with neuropsychological function in early and late onset Alzheimer's disease (AD).

METHODS

We included 107 patients with sporadic AD (21 early onset and 86 late onset) from our memory clinic. Tests for (working) memory, language, executive function, mental speed, and attention were administered. Global atrophy and global and lobar WMH were measured using 1 Tesla MRI. Linear regression analyses with terms for MRI measures, neuropsychological test results, age, gender, education, and the interaction between separate brain measures and age of onset were performed.

RESULTS

Global atrophy was associated with more severely impaired global cognition, working memory, mental speed, and executive function (p < 0.05). Significant interactions between global atrophy and age at onset showed that these associations were mostly attributable to patients with early onset AD. By contrast, an association between global atrophy and memory was found, which was specifically attributable to late onset AD patients. No associations between global WMH and cognitive function were found. Subsequently we analyzed regional WMH and found that temporal WMH was associated with impaired memory, and frontal WMH was associated with slower mental speed.

CONCLUSION

Cortical atrophy, a key feature of AD, is linked to a wide range of cognitive functions, specifically in early onset AD patients. For WMH, there were no interactions with age at onset, but we found specific associations between temporal WMH and memory and frontal WMH and mental speed.

摘要

目的

评估全球萎缩和白质高信号(WMH)与早发性和晚发性阿尔茨海默病(AD)患者神经心理学功能的相关性。

方法

我们纳入了来自我们记忆诊所的 107 例散发性 AD 患者(21 例早发性和 86 例晚发性)。进行了(工作)记忆、语言、执行功能、心理速度和注意力测试。使用 1 特斯拉 MRI 测量整体萎缩以及整体和脑叶 WMH。进行了线性回归分析,包括 MRI 测量指标、神经心理学测试结果、年龄、性别、教育程度以及单独脑部测量指标与发病年龄之间的交互作用。

结果

全球萎缩与全球认知功能、工作记忆、心理速度和执行功能受损更严重相关(p < 0.05)。全球萎缩与发病年龄之间存在显著的交互作用,表明这些相关性主要归因于早发性 AD 患者。相比之下,在晚发性 AD 患者中发现了全球萎缩与记忆之间的关联。未发现全球 WMH 与认知功能之间存在相关性。随后我们分析了区域性 WMH,发现颞叶 WMH 与记忆受损相关,额叶 WMH 与心理速度较慢相关。

结论

AD 的一个关键特征是皮质萎缩,与广泛的认知功能相关,特别是在早发性 AD 患者中。对于 WMH,与发病年龄之间没有交互作用,但我们发现了颞叶 WMH 与记忆之间以及额叶 WMH 与心理速度之间的特定关联。

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