Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, Parkwood Research Institute, London, Canada.
Lawson Health Research Institute, London, Canada.
J Alzheimers Dis. 2017;60(3):1161-1170. doi: 10.3233/JAD-170348.
Neuropsychiatric symptoms in Alzheimer's disease are among the most disabling and difficult aspects for caregivers and treating health professionals to manage. Despite the high prevalence of these behaviors, little is known about the factors which lead some patients to develop florid behavioral symptoms while others may progress to severe dementia without such phenomenon. We examined whether regional brain volumes as measured by cortical thickness would predict the presence or absence of disinhibition in patients with Alzheimer's disease. Using data from the ADNI, we identified 758 patients with caregiver ratings on the Neuropsychiatric Inventory and a volumetric MRI scan with cortical thickness measurements completed in FreeSurfer by the UCSF core. Of these, 177 patients were found to have disinhibition. Logistic regression models demonstrated that reduced cortical thickness in the right frontal pole was associated with the presence of disinhibition even when controlling for age, disease severity, total intracranial volume, gender, and APOE genotype. The results are considered in the context of leading models of the functions of frontopolar cortex.
阿尔茨海默病患者的神经精神症状是照护者和治疗医护人员最难管理的症状之一。尽管这些行为很常见，但对于导致一些患者出现明显行为症状，而另一些患者则进展为严重痴呆而没有这种现象的因素知之甚少。我们研究了皮质厚度测量的大脑区域体积是否可以预测阿尔茨海默病患者是否存在抑制障碍。我们使用 ADNI 的数据，在有照护者评分的神经精神疾病问卷和 UCSF 核心的 FreeSurfer 完成的皮质厚度测量的容积 MRI 扫描中，确定了 758 名患者。其中，有 177 名患者出现了抑制障碍。逻辑回归模型表明，即使在控制年龄、疾病严重程度、总颅内体积、性别和 APOE 基因型后，右侧额极皮质变薄与抑制障碍的存在相关。这些结果是在额极皮层功能的主要模型的背景下考虑的。
