阿尔茨海默病连续谱中的皮质微观结构变化。

Cortical microstructural changes along the Alzheimer's disease continuum.

机构信息

Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain.

Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Alzheimers Dement. 2018 Mar;14(3):340-351. doi: 10.1016/j.jalz.2017.09.013. Epub 2017 Oct 31.

DOI:10.1016/j.jalz.2017.09.013

PMID:29080407

Abstract

INTRODUCTION

Cortical mean diffusivity (MD) and free water fraction (FW) changes are proposed biomarkers for Alzheimer's disease (AD).

METHODS

We included healthy control subjects (N = 254), mild cognitive impairment (N = 41), and AD dementia (N = 31) patients. Participants underwent a lumbar puncture and a 3 T magnetic resonance imaging. Healthy control subjects were classified following National Institute on Aging-Alzheimer's Association stages (stage 0, N = 220; stage 1, N = 25; and stage 2/3, N = 9). We assessed the cortical MD, cortical FW, and cortical thickness (CTh) changes along the AD continuum.

RESULTS

Microstructural and macrostructural changes show a biphasic trajectory. Stage 1 subjects showed increased CTh and decreased MD and FW with respect the stage 0 subjects. Stage 2/3 subjects showed decreased CTh and increased cortical MD and FW, changes that were more widespread in symptomatic stages.

DISCUSSION

These results support a biphasic model of changes in AD, which could affect the selection of patients for clinical trials and the use of magnetic resonance imaging as a surrogate marker of disease modification.

摘要

简介

皮质平均扩散度（MD）和游离水分数（FW）的变化被认为是阿尔茨海默病（AD）的生物标志物。

方法

我们纳入了健康对照组（N=254）、轻度认知障碍（MCI，N=41）和 AD 痴呆（N=31）患者。参与者接受了腰椎穿刺和 3T 磁共振成像检查。健康对照组根据美国国家老龄化研究所-阿尔茨海默病协会的阶段进行分类（阶段 0，N=220；阶段 1，N=25；阶段 2/3，N=9）。我们评估了 AD 连续体中皮质 MD、皮质 FW 和皮质厚度（CTh）的变化。