Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK.
Alzheimers Dement. 2017 Sep;13(9):1013-1023. doi: 10.1016/j.jalz.2017.01.019. Epub 2017 Mar 3.
Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear.
Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini-Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed.
An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of -8.0% (95% credible interval: [-11.5, -5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology, F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid markers (-8.5, CrI: [-11.5, -5.6]; -14.1, CrI: [-19.3, -8.8]; -10.6, CrI: [-14.6, -6.1], respectively).
There is a measurable effect of hippocampal volume on DCAD even when used on top of the traditional diagnostic workup.
海马体积是阿尔茨海默病（AD）的核心生物标志物。然而，其在标准诊断中的贡献尚不清楚。
在 17 家欧洲记忆诊所中，共招募了 356 名患有认知障碍、疑似 AD 且 Mini-Mental State Examination≥20 分的患者。在进行传统的诊断评估后，由主治医生评估 AD 病理的诊断信心（DCAD）。主治医生以标准化格式提供自动海马体积测量结果，并重新评估 DCAD。
海马体积增加一个四分位距与 DCAD 的平均变化为-8.0%（95%可信区间：[-11.5，-5.0]）。自动海马体积测量结果在神经心理学、F-氟脱氧葡萄糖正电子发射断层扫描/单光子发射计算机断层扫描和脑脊液标志物的贡献之外，对 DCAD 具有统计学显著影响（-8.5，CrI：[-11.5，-5.6]；-14.1，CrI：[-19.3，-8.8]；-10.6，CrI：[-14.6，-6.1]）。
即使在传统诊断评估的基础上，海马体积对 DCAD 仍有可衡量的影响。
