Meyer Patric, Feldkamp Hanna, Hoppstädter Michael, King Andrea V, Frölich Lutz, Wessa Michèle, Flor Herta
Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany.
Front Behav Neurosci. 2013 Jul 23;7:89. doi: 10.3389/fnbeh.2013.00089. eCollection 2013.
Alzheimer's disease (AD) is a slowly progressive neurodegenerative disorder, in which morphological alterations of brain tissue develop many years before the first neuropsychological and clinical changes occur. Among the first and most prominent symptoms are deficiencies of declarative memory functions. This stage of precursory symptoms to AD has been described as amnestic mild cognitive impairment (aMCI) and is discussed as a potential AD prodrome. As therapy in the later stages of AD has been shown to be of limited impact, aMCI would be the key target for early intervention. For that purpose a comprehensive neuropsychological and anatomical characterization of this group is necessary. Previous neuropsychological investigations identified tests which are highly sensitive in diagnosing aMCI and very early AD. However, the sensitivity of those neuropsychological tests to the particular structural neuropathology in aMCI remains to be specified. To this end, we investigated 25 patients with single-domain aMCI. All participants underwent extensive neuropsychological testing and anatomical scanning with structural magnetic resonance imaging. Voxel-based morphometry (VBM) was performed to identify brain regions that show a significant correlation between regional brain volume and behavioral measures of memory and executive functioning. We found that performance in a variety of mnemonic tests was directly related to the integrity of the medial temporal lobe cortex (MTLC). Moreover, impairment of memory sub-functions in aMCI might be detected earlier than overt structural damage. By this, these findings contribute to the identification of cerebral structures associated with memory deficits in aMCI.
阿尔茨海默病（AD）是一种缓慢进展的神经退行性疾病，其中脑组织的形态学改变在首次出现神经心理学和临床变化的许多年前就已发生。最早且最突出的症状之一是陈述性记忆功能缺陷。AD前驱症状的这个阶段被描述为遗忘型轻度认知障碍（aMCI），并被视为潜在的AD前驱期。由于已证明在AD后期进行治疗的效果有限，aMCI将成为早期干预的关键目标。为此，有必要对该群体进行全面的神经心理学和解剖学特征分析。先前的神经心理学研究确定了在诊断aMCI和极早期AD时高度敏感的测试。然而，这些神经心理学测试对aMCI中特定结构神经病理学的敏感性仍有待明确。为此，我们对25名单领域aMCI患者进行了研究。所有参与者都接受了广泛的神经心理学测试以及使用结构磁共振成像进行的解剖学扫描。采用基于体素的形态学测量（VBM）来确定在区域脑容量与记忆和执行功能的行为测量之间显示出显著相关性的脑区。我们发现，各种记忆测试中的表现与内侧颞叶皮质（MTLC）的完整性直接相关。此外，aMCI中记忆子功能的损害可能比明显的结构损伤更早被检测到。由此，这些发现有助于识别与aMCI中记忆缺陷相关的脑结构。
