Carlesimo Giovanni A, Piras Fabrizio, Orfei Maria Donata, Iorio Mariangela, Caltagirone Carlo, Spalletta Gianfranco
Department of Neuroscience, Tor Vergata University, Rome, Italy; Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Rome, Italy.
Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Rome, Italy.
Alzheimers Dement (Amst). 2015 Mar 29;1(1):24-32. doi: 10.1016/j.dadm.2014.12.001. eCollection 2015 Mar.
There is no consensus about which hippocampal subfields become atrophic earliest in the course of Alzheimer's disease (AD).
Thirty AD patients, 41 mild cognitive impairment (MCI) patients, and 38 healthy controls (HCs) underwent cerebral magnetic resonance imaging (with an automated segmentation protocol for the volumetric analysis of hippocampal subfields) and a test of immediate and delayed recall of a 15-word list.
The volumes of the presubiculum and subiculum presented the most remarkable reduction in the patient's groups. In the MCI group, only the volumes of presubiculum and subiculum predicted performance on the memory tests. In AD patients, the volumes of all hippocampal subfields (with the notable exception of the CA1) predicted memory scores.
Our data point to a prevalent atrophy of the presubicular-subicular complex from the early phases of AD. This finding is consistent with neuropathological observations in AD patients and probably reflects the severe degeneration of the perforant pathway while penetrating the hippocampus through the subicular field in its course from the entorhinal cortex to the dentate gyrus.
关于在阿尔茨海默病（AD）病程中哪些海马亚区最早出现萎缩，目前尚无共识。
30例AD患者、41例轻度认知障碍（MCI）患者和38例健康对照（HC）接受了脑磁共振成像（采用自动分割协议对海马亚区进行体积分析）以及对一个包含15个单词的列表进行即时和延迟回忆的测试。
患者组中，前下托和下托的体积减少最为显著。在MCI组中，只有前下托和下托的体积能够预测记忆测试的表现。在AD患者中，所有海马亚区（CA1除外）的体积均能预测记忆得分。
我们的数据表明，从AD早期阶段开始，前下托 - 下托复合体普遍萎缩。这一发现与AD患者的神经病理学观察结果一致，可能反映了穿通通路在从内嗅皮质到齿状回的过程中穿过下托区进入海马时的严重退化。
