Juh R, Suh T, Kim S
Asan Medical Center, Seoul.
Catholic University Medical College, Seoul.
Med Phys. 2012 Jun;39(6Part5):3641. doi: 10.1118/1.4734790.
We evaluated the relationship between white matter (WM) tract disintegration and gray matter (GM) atrophy in patients with Alzheimer's disease (AD), mild cognitive impairment (MCI) and controls, using diffusion tensor imaging (DTI) and an optimized voxel-based analysis.
Two hundred thirty one individuals (61 controls, 116 MCI and 54 AD) were included. Voxel-based WM tract statistics was used to obtain whole-brain maps of WM bundles for FA. Voxel-based morphometry (VBM) was conducted to detect regions of gray matter (GM) atrophy in the AD, MCI group relative to the control group. FA maps were processed to make voxel-wise comparison of tract based analysis in whole brain between each the two groups. The relationship between locations of abnormalities in the WM and GM were examined.
Patients with AD showed significant GM atrophy in posterior cingulate gyrus (BA31, 32) to the precuneus, the middle temporal lobe (BA19), the superior frontal (BA9) to the anterior cingulate (BA 32), the medial frontal lobe (BA 11, BA25), the hippocampus, the parahippocampal gyrus (BA30/34) and the insula, and WM tract disintegrity of the uncinate fasciculus, posterior cingulate fasciculus and fornix compared with the control and MCI groups. These abnormalities in the AD group were caused by either structural changes in GM atrophy or neural dysfunction due to functional disconnections in the WM tract.
The GM atrophy resulting from WM tract disintegration or GM atrophy itself may be the first step in the AD process, resulting in anatomically congruent correlations between WM disintegration and regional GM atrophy. Using tract based spatial statistics and voxel based analysis, both of which are useful in investigating GM and WM changes in individuals with neurodegenerative disorders.
我们使用扩散张量成像(DTI)和优化的基于体素的分析方法,评估阿尔茨海默病(AD)、轻度认知障碍(MCI)患者及对照组中白质(WM)束解体与灰质(GM)萎缩之间的关系。
纳入231名个体(61名对照组、116名MCI患者和54名AD患者)。基于体素的WM束统计用于获取FA的全脑WM束图谱。进行基于体素的形态计量学(VBM)以检测AD、MCI组相对于对照组的灰质(GM)萎缩区域。对FA图谱进行处理,以对两组之间全脑基于束的分析进行体素水平比较。检查WM和GM异常位置之间的关系。
与对照组和MCI组相比,AD患者在扣带回后部(BA31、32)至楔前叶、颞中叶(BA19)、额上回(BA9)至前扣带回(BA32)、额内侧叶(BA11、BA25)、海马、海马旁回(BA30/34)和脑岛存在显著的GM萎缩,以及钩束、扣带回后部束和穹窿的WM束解体。AD组的这些异常是由GM萎缩的结构变化或WM束功能断开导致的神经功能障碍引起的。
WM束解体或GM萎缩本身导致的GM萎缩可能是AD进程的第一步,导致WM解体与区域GM萎缩之间在解剖学上具有一致性关联。使用基于束的空间统计和基于体素的分析,这两种方法都有助于研究神经退行性疾病个体的GM和WM变化。