Liang Peipeng, Xiang Jie, Liang Hong, Qi Zhigang, Li Kuncheng
Xuanwu Hospital, Capital Medical University, 45 Chang Chun Street, Xi Cheng District, Beijing 100053, China.
Curr Alzheimer Res. 2014 May;11(4):389-98. doi: 10.2174/1567205011666140331225335.
Previous studies have shown that the strength of the low frequency fluctuation in the medial-line brain areas are abnormally reduced in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients. The purpose of this study was to explore the functional brain changes in early MCI (EMCI) and late MCI (LMCI) patients by measuring the amplitude of the blood oxygenation level dependent (BOLD) functional MRI (fMRI) signals at rest.
35 elderly normal controls (NC), 24 EMCI, 29 LMCI, and 14 AD patients from the Alzheimer's Disease Neuroimaging Initiative (ADNI2) were included in this study. Resting state fMRI and 3D structural MRI data were acquired. The spatial patterns of spontaneous brain activity were measured by examining the amplitude of low-frequency fluctuations (ALFF) of BOLD signal during rest. A one-way analysis of variance (ANOVA) was then performed on ALFF maps, with age, sex and regional atrophy as covariates.
There were widespread ALFF differences among the four groups. As compared with controls, AD, LMCI and EMCI patients showed decreased ALFF mainly in the posterior cingulate cortex, precuneus, right lingual gyrus and thalamus (with a linear trend: NC>EMCI>LMCI>AD), while there was increased activity in the right parahippocampal gyrus (with a linear trend: NC<EMCI<LMCI<AD). Additionally, we also showed that many regions with ALFF changes had significant correlations with the cognitive performance as measured by mini-mental state examination scores (MMSE) and the emotion states as measured by Geriatric Depression Scale (GD scale) for EMCI, LMCI and AD patients, but not for controls.
Our results indicated that the significantly altered ALFF activities can be detected at EMCI stage, independent of age, sex and regional atrophy. The present study thus suggests ALFF abnormalities as a potential biomarker for the early diagnosis of AD and further provides insights into biological mechanisms of the diseases.
先前的研究表明,轻度认知障碍(MCI)和阿尔茨海默病(AD)患者中线脑区低频波动的强度异常降低。本研究的目的是通过测量静息状态下血氧水平依赖(BOLD)功能磁共振成像(fMRI)信号的幅度,探索早期MCI(EMCI)和晚期MCI(LMCI)患者的脑功能变化。
本研究纳入了来自阿尔茨海默病神经影像倡议(ADNI2)的35名老年正常对照(NC)、24名EMCI、29名LMCI和14名AD患者。采集了静息态fMRI和三维结构MRI数据。通过检查静息期间BOLD信号的低频波动幅度(ALFF)来测量自发脑活动的空间模式。然后对ALFF图进行单因素方差分析(ANOVA),将年龄、性别和区域萎缩作为协变量。
四组之间存在广泛的ALFF差异。与对照组相比,AD、LMCI和EMCI患者主要在后扣带回皮质、楔前叶、右侧舌回和丘脑的ALFF降低(呈线性趋势:NC>EMCI>LMCI>AD),而右侧海马旁回的活动增加(呈线性趋势:NC<EMCI<LMCI<AD)。此外,我们还表明,对于EMCI、LMCI和AD患者,许多ALFF发生变化的区域与通过简易精神状态检查评分(MMSE)测量的认知表现以及通过老年抑郁量表(GD量表)测量的情绪状态显著相关,但对照组则不然。
我们的结果表明,在EMCI阶段可以检测到ALFF活动的显著改变,且不受年龄、性别和区域萎缩的影响。本研究因此表明ALFF异常作为AD早期诊断的潜在生物标志物,并进一步为疾病的生物学机制提供了见解。