Hu Zhongjie, Wu Liyong, Jia Jianping, Han Ying
Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China.
Neurosci Bull. 2014 Apr;30(2):198-206. doi: 10.1007/s12264-013-1407-y. Epub 2014 Feb 27.
Amnestic mild cognitive impairment (aMCI) is a prodromal stage of Alzheimer's disease (AD), and 75%-80% of aMCI patients finally develop AD. So, early identification of patients with aMCI or AD is of great significance for prevention and intervention. According to cross-sectional studies, it is known that the hippocampus, posterior cingulate cortex, and corpus callosum are key areas in studies based on structural MRI (sMRI), functional MRI (fMRI), and diffusion tensor imaging (DTI) respectively. Recently, longitudinal studies using each MRI modality have demonstrated that the neuroimaging abnormalities generally involve the posterior brain regions at the very beginning and then gradually affect the anterior areas during the progression of aMCI to AD. However, it is not known whether follow-up studies based on multi-modal neuroimaging techniques (e.g., sMRI, fMRI, and DTI) can help build effective MRI models that can be directly applied to the screening and diagnosis of aMCI and AD. Thus, in the future, large-scale multi-center follow-up studies are urgently needed, not only to build an MRI diagnostic model that can be used on a single person, but also to evaluate the variability and stability of the model in the general population. In this review, we present longitudinal studies using each MRI modality separately, and then discuss the future directions in this field.
遗忘型轻度认知障碍（aMCI）是阿尔茨海默病（AD）的前驱阶段，75%-80%的aMCI患者最终会发展为AD。因此，早期识别aMCI或AD患者对于预防和干预具有重要意义。根据横断面研究可知，海马体、后扣带回皮质和胼胝体分别是基于结构磁共振成像（sMRI）、功能磁共振成像（fMRI）和扩散张量成像（DTI）研究的关键区域。最近，使用每种磁共振成像方式的纵向研究表明，神经影像学异常通常在一开始就累及后脑区域，然后在aMCI进展为AD的过程中逐渐影响前脑区域。然而，基于多模态神经影像学技术（如sMRI、fMRI和DTI）的随访研究是否有助于建立可直接应用于aMCI和AD筛查与诊断的有效磁共振成像模型尚不清楚。因此，未来迫切需要大规模多中心随访研究，不仅要建立可用于个体的磁共振成像诊断模型，还要评估该模型在普通人群中的变异性和稳定性。在这篇综述中，我们分别介绍了使用每种磁共振成像方式的纵向研究，然后讨论了该领域的未来方向。
