Ferrarini Luca, van Lew Baldur, Reiber Johan H C, Gandin Claudia, Galluzzo Lucia, Scafato Emanuele, Frisoni Giovanni B, Milles Julien, Pievani Michela
LKEB - Division of Image Processing,Department of Radiology,Leiden University Medical Center,Leiden,the Netherlands.
National Center on Epidemiology,Surveillance and Health Promotion,Istituto Superiore di Sanità,Rome,Italy.
Int Psychogeriatr. 2014 Jul;26(7):1067-81. doi: 10.1017/S1041610213002627. Epub 2014 Feb 13.
Clinical studies have shown that hippocampal atrophy is present before dementia in people with memory deficits and can predict dementia development. The question remains whether this association holds in the general population. This is of interest for the possible use of hippocampal atrophy to screen population for preventive interventions. The aim of this study was to assess hippocampal volume and shape abnormalities in elderly adults with memory deficits in a cross-sectional population-based study.
We included individuals participating in the Italian Project on the Epidemiology of Alzheimer Disease (IPREA) study: 75 cognitively normal individuals (HC), 31 individuals with memory deficits (MEM), and 31 individuals with memory deficits not otherwise specified (MEMnos). Hippocampal volumes and shape were extracted through manual tracing and the growing and adaptive meshes (GAMEs) shape-modeling algorithm. We investigated between-group differences in hippocampal volume and shape, and correlations with memory deficits.
In MEM participants, hippocampal volumes were significantly smaller than in HC and were mildly associated with worse memory scores. Memory-associated shape changes mapped to the anterior hippocampus. Shape-based analysis detected no significant difference between MEM and HC, while MEMnos showed shape changes in the posterior hippocampus compared with HC and MEM groups.
These findings support the discriminant validity of hippocampal volumetry as a biomarker of memory impairment in the general population. The detection of shape changes in MEMnos but not in MEM participants suggests that shape-based biomarkers might lack sensitivity to detect Alzheimer's-like pathology in the general population.
临床研究表明，在有记忆缺陷的人群中，海马萎缩在痴呆出现之前就已存在，并且可以预测痴呆的发展。问题在于这种关联在普通人群中是否成立。这对于利用海马萎缩来筛查人群以进行预防性干预具有重要意义。本研究的目的是在一项基于人群的横断面研究中评估有记忆缺陷的老年人的海马体积和形状异常。
我们纳入了参与意大利阿尔茨海默病流行病学项目（IPREA）研究的个体：75名认知正常个体（HC）、31名有记忆缺陷个体（MEM）和31名未明确说明的有记忆缺陷个体（MEMnos）。通过手动追踪以及生长和自适应网格（GAMEs）形状建模算法提取海马体积和形状。我们研究了海马体积和形状的组间差异以及与记忆缺陷的相关性。
在MEM参与者中，海马体积显著小于HC组，并且与较差的记忆分数轻度相关。与记忆相关的形状变化映射到海马前部。基于形状的分析未检测到MEM和HC之间存在显著差异，而与HC组和MEM组相比，MEMnos组在海马后部显示出形状变化。
这些发现支持了海马体积测量作为普通人群记忆障碍生物标志物的判别效度。在MEMnos组而非MEM参与者中检测到形状变化，这表明基于形状的生物标志物可能缺乏在普通人群中检测类似阿尔茨海默病病理的敏感性。
