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发现阿尔茨海默病患者的尾状核增大。

Finding of increased caudate nucleus in patients with Alzheimer's disease.

机构信息

Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.

Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway.

出版信息

Acta Neurol Scand. 2018 Feb;137(2):224-232. doi: 10.1111/ane.12800. Epub 2017 Jul 25.

Abstract

OBJECTIVES

A recently published study using an automated MRI volumetry method (NeuroQuant®) unexpectedly demonstrated larger caudate nucleus volume in patients with Alzheimer's disease dementia (AD) compared to patients with subjective and mild cognitive impairment (SCI and MCI). The aim of this study was to explore this finding.

MATERIALS & METHODS: The caudate nucleus and the hippocampus volumes were measured (both expressed as ratios of intracranial volume) in a total of 257 patients with SCI and MCI according to the Winblad criteria and AD according to ICD-10 criteria. Demographic data, cognitive measures, and APOE-ɛ4 status were collected.

RESULTS

Compared with non-dementia patients (SCI and MCI), AD patients were older, more of them were female, and they had a larger caudate nucleus volume and smaller hippocampus volume (P<.001). In multiple linear regression analysis, age and female sex were associated with larger caudate nucleus volume, but neither diagnosis nor memory function was. Age, gender, and memory function were associated with hippocampus volume, and age and memory function were associated with caudate nucleus/hippocampus ratio.

CONCLUSIONS

A larger caudate nucleus volume in AD patients was partly explained by older age and being female. These results are further discussed in the context of (1) the caudate nucleus possibly serving as a mechanism for temporary compensation; (2) methodological properties of automated volumetry of this brain region; and (3) neuropathological alterations. Further studies are needed to fully understand the role of the caudate nucleus in AD.

摘要

目的

最近发表的一项研究使用自动 MRI 容积测量方法(NeuroQuant®),出乎意料地发现阿尔茨海默病痴呆(AD)患者的尾状核体积大于主观认知障碍和轻度认知障碍(SCI 和 MCI)患者。本研究旨在探讨这一发现。

材料与方法

根据 Winblad 标准对 257 例 SCI 和 MCI 患者,以及根据 ICD-10 标准对 AD 患者进行了尾状核和海马体积的测量(均以颅内体积比表示)。收集了人口统计学数据、认知测量和 APOE-ɛ4 状态。

结果

与非痴呆患者(SCI 和 MCI)相比,AD 患者年龄更大,女性更多,尾状核体积更大,海马体积更小(P<.001)。在多元线性回归分析中,年龄和女性与尾状核体积增大有关,而诊断和记忆功能均与尾状核体积无关。年龄、性别和记忆功能与海马体积有关,年龄和记忆功能与尾状核/海马体积比有关。

结论

AD 患者尾状核体积增大部分归因于年龄较大和女性。这些结果在以下背景下进一步讨论:(1)尾状核可能作为一种临时代偿机制;(2)该脑区自动容积测量的方法学特性;(3)神经病理学改变。需要进一步研究以充分了解尾状核在 AD 中的作用。

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