Departments of ∥Neurology, Memory Disorders Clinic *Radiology, Charles University, 2nd Faculty of Medicine, University Hospital Motol §Department of Neurosurgery, Charles University in Prague, 1st Faculty of Medicine, University Central Military Hospital #Department of Radiodiagnostics, University Central Military Hospital, Prague †International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic ‡Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine **Neuroscience Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary ¶Department of Biomedical Engineering, Mayo Clinic, Rochester, MN.
Alzheimer Dis Assoc Disord. 2014 Jan-Mar;28(1):65-72. doi: 10.1097/WAD.0b013e318299d3d6.
Brain atrophy is a key imaging hallmark of Alzheimer disease (AD). In this study, we carried out an integrative evaluation of AD-related atrophy. Twelve patients with AD and 13 healthy controls were enrolled. We conducted a cross-sectional analysis of total brain tissue volumes with SIENAX. Localized gray matter atrophy was identified with optimized voxel-wise morphometry (FSL-VBM), and subcortical atrophy was evaluated by active shape model implemented in FMRIB's Integrated Registration Segmentation Toolkit. SIENAX analysis demonstrated total brain atrophy in AD patients; voxel-based morphometry analysis showed atrophy in the bilateral mediotemporal regions and in the posterior brain regions. In addition, regarding the diminished volumes of thalami and hippocampi in AD patients, subsequent vertex analysis of the segmented structures indicated shrinkage of the bilateral anterior thalami and the left medial hippocampus. Interestingly, the volume of the thalami and hippocampi were highly correlated with the volume of the thalami and amygdalae on both sides in AD patients, but not in healthy controls. This complex structural information proved useful in the detailed interpretation of AD-related neurodegenerative process, as the multilevel approach showed both global and local atrophy on cortical and subcortical levels. Most importantly, our results raise the possibility that subcortical structure atrophy is not independent in AD patients.
脑萎缩是阿尔茨海默病（AD）的一个关键影像学标志。在这项研究中，我们对 AD 相关的萎缩进行了综合评估。纳入了 12 名 AD 患者和 13 名健康对照者。我们使用 SIENAX 进行了全脑组织体积的横断面分析。使用优化的体素形态计量学（FSL-VBM）确定局部灰质萎缩，通过 FMRIB 的集成注册分割工具包中的主动形状模型评估皮质下萎缩。SIENAX 分析显示 AD 患者存在全脑萎缩；基于体素的形态计量学分析显示双侧颞叶中部和后脑部萎缩。此外，AD 患者的丘脑和海马体积减小，随后对分割结构的顶点分析表明双侧前丘脑和左侧内侧海马萎缩。有趣的是，AD 患者的丘脑和海马体积与双侧丘脑和杏仁核体积高度相关，但在健康对照组中则没有。这种复杂的结构信息在详细解释 AD 相关的神经退行性过程中非常有用，因为多层次方法显示了皮质和皮质下水平的全局和局部萎缩。最重要的是，我们的结果表明 AD 患者的皮质下结构萎缩并非独立发生。
