阿尔茨海默病中结构连接性的震中破坏。
Epicentral disruption of structural connectivity in Alzheimer's disease.
作者信息
Mallio Carlo Augusto, Schmidt Ruben, de Reus Marcel A, Vernieri Fabrizio, Quintiliani Livia, Curcio Giuseppe, Beomonte Zobel Bruno, Quattrocchi Carlo Cosimo, van den Heuvel Martijn P
机构信息
Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging, Università Campus Bio-Medico di Roma, Rome, Italy.
Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands.
出版信息
CNS Neurosci Ther. 2015 Oct;21(10):837-45. doi: 10.1111/cns.12397. Epub 2015 Apr 21.
AIMS
Neurodegenerative changes observed in Alzheimer's disease (AD) have been suggested to begin at the entorhinal cortex and hippocampus and then to propagate in a stereotypical fashion. Using diffusion-weighted imaging, we test whether disruption of structural connectivity in AD is centered on these "epicenters of disease".
METHODS
Fifteen healthy controls, 14 amnestic mild cognitive impairment (aMCI), 13 mild, and 15 moderate patients with AD were enrolled. The percentages of affected connections directly linking to the epicenter (named first ring) and to nodes with topological distance 2 from the epicenter (named second ring) were calculated.
RESULTS
For the group of aMCI patients, just 5.3% of the first ring (n.s.) and 2.9% of the second ring (n.s.) connections were affected. However, for mild AD there was disruption involving 20% of the first ring (P < 0.0001) and 10.3% of the second ring (P < 0.0001) connections. In the moderate AD group, a stronger effect was observed, with 38.0% of the first ring (P < 0.0001) connections and 17.9% of the second ring (P < 0.0001) connections affected.
CONCLUSION
Our results favor an epicentral disruption of structural connectivity in aMCI and AD around entorhinal and hippocampal regions, consistent with the transneuronal spread hypothesis.
目的
有研究表明，阿尔茨海默病（AD）中观察到的神经退行性变化始于内嗅皮质和海马体，然后以一种刻板的方式传播。我们使用扩散加权成像来测试AD中结构连接性的破坏是否以这些“疾病震中”为中心。
方法
招募了15名健康对照者、14名遗忘型轻度认知障碍（aMCI）患者、13名轻度AD患者和15名中度AD患者。计算直接连接到震中（称为第一环）以及与震中拓扑距离为2的节点（称为第二环）的受影响连接的百分比。
结果
对于aMCI患者组，第一环连接中仅有5.3%（无统计学意义）和第二环连接中2.9%（无统计学意义）受到影响。然而，对于轻度AD患者，第一环连接中有20%（P<0.0001）和第二环连接中有10.3%（P<0.0001）受到破坏。在中度AD组中，观察到更强的影响，第一环连接中有38.0%（P<0.0001）和第二环连接中有17.9%（P<0.0001）受到影响。
结论
我们的结果支持在内嗅和海马区域周围的aMCI和AD中结构连接性的震中破坏，这与跨神经元传播假说一致。
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