Alves Gilberto Sousa, Oertel Knöchel Viola, Knöchel Christian, Carvalho André Férrer, Pantel Johannes, Engelhardt Eliasz, Laks Jerson
Translational Psychiatry Research Group, Department of Clinical Medicine, Federal University of Ceara, Rua Professor Costa Mendes 1608, 4° Andar, Rodolfo Teófilo, 60430140 Fortaleza, CE, Brazil ; Institute for General Medicine, Goethe University, 60590 Frankfurt am Main, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatics, Goethe University, 60528 Frankfurt am Main, Germany.
Biomed Res Int. 2015;2015:291658. doi: 10.1155/2015/291658. Epub 2015 Jan 20.
Microstructural abnormalities in white matter (WM) are often reported in Alzheimer's disease (AD) and may reflect primary or secondary circuitry degeneration (i.e., due to cortical atrophy). The interpretation of diffusion tensor imaging (DTI) eigenvectors, known as multiple indices, may provide new insights into the main pathological models supporting primary or secondary patterns of WM disruption in AD, the retrogenesis, and Wallerian degeneration models, respectively. The aim of this review is to analyze the current literature on the contribution of DTI multiple indices to the understanding of AD neuropathology, taking the retrogenesis model as a reference for discussion. A systematic review using MEDLINE, EMBASE, and PUBMED was performed. Evidence suggests that AD evolves through distinct patterns of WM disruption, in which retrogenesis or, alternatively, the Wallerian degeneration may prevail. Distinct patterns of WM atrophy may be influenced by complex interactions which comprise disease status and progression, fiber localization, concurrent risk factors (i.e., vascular disease, gender), and cognitive reserve. The use of DTI multiple indices in addition to other standard multimodal methods in dementia research may help to determine the contribution of retrogenesis hypothesis to the understanding of neuropathological hallmarks that lead to AD.
在阿尔茨海默病（AD）中，常报道存在白质（WM）微观结构异常，这可能反映了原发性或继发性神经回路退化（即由于皮质萎缩）。扩散张量成像（DTI）特征向量的解释，即多个指标，可能分别为支持AD中WM破坏的主要病理模型、逆行性退变和华勒氏变性模型提供新的见解。本综述的目的是以逆行性退变模型作为讨论参考，分析当前关于DTI多个指标对理解AD神经病理学贡献的文献。使用MEDLINE、EMBASE和PUBMED进行了系统综述。有证据表明，AD通过不同的WM破坏模式发展，其中逆行性退变或华勒氏变性可能占主导。WM萎缩的不同模式可能受复杂相互作用的影响，这些相互作用包括疾病状态和进展、纤维定位、并发风险因素（即血管疾病、性别）和认知储备。在痴呆症研究中，除了其他标准多模态方法外，使用DTI多个指标可能有助于确定逆行性退变假说对理解导致AD的神经病理学特征的贡献。
