Sheelakumari R, Kesavadas C, Lekha V S, Justus Sunitha, Sarma P Sankara, Menon Ramshekhar
Cognition and Behavioural Neurology Section, Department of Neurology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Department of Imaging Sciences and Interventional Radiology, Biostatistics Sree ChitraTirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Neurol India. 2018 Mar-Apr;66(2):370-376. doi: 10.4103/0028-3886.227298.
: Annually 10-12% of patients with mild cognitive impairment (MCI) are likely to progress to Alzheimer's Disease (AD). The morphometric profile in stable non-converters has not been adequately characterized.
To determine the structural differences between amnestic MCI and early AD using volumetric magnetic resonance imaging (MRI) and its correlation with neuropsychological test performances.
: This was a hospital-based case-control study.
: Twenty-four patients classified as having "non-progressor" MCI, 13 as having an early AD, and 25 controls, and assessed using neuropsychological evaluation, and three-dimensional T1-weighted 1.5T magnetic resonance maging (MRI) were included in the study. We used both voxel-based morphometry and automated regional volumetry to assess the topographical patterns of volume loss.
Post-hoc analysis of variance was done for comparison between means, and partial correlation analysis was done for correlating volumetric and cognitive measures.
: Consistently, significant atrophy of the superior temporal gyrus, left hippocampus, and mesial frontoparietal regions were identified in patients with MCI in comparison to controls. Increased atrophy in the limbic regions, temporal neocortex, and precuneus was identified in patients with early AD in comparison to patients with MCI. While differences in retention and recall scores between the groups were independent of age and volumetric variables, significant correlations were observed between the learning and recall scores and the volume of hippocampus in patients with MCI as well as temporal neocortex in patients with AD. Atrophy of the superior temporal gyrus and mesial neocortical regions represents the structural correlate of amnestic MCI parallel to the development of hippocampal atrophy.
: Identification of the pattern of volumetric abnormalities in patients with amnestic MCI in addition to atrophy of the medial temporal lobes necessitates a close follow up to continuously assess these patients for their progression to early AD.
每年有10% - 12%的轻度认知障碍（MCI）患者可能会进展为阿尔茨海默病（AD）。稳定的非进展者的形态学特征尚未得到充分描述。
使用容积磁共振成像（MRI）确定遗忘型MCI与早期AD之间的结构差异及其与神经心理学测试表现的相关性。
这是一项基于医院的病例对照研究。
本研究纳入了24例被归类为“非进展型”MCI的患者、13例早期AD患者和25例对照者，并使用神经心理学评估和三维T1加权1.5T磁共振成像（MRI）进行评估。我们使用基于体素的形态学测量和自动区域容积测量来评估体积损失的地形模式。
进行事后方差分析以比较均值，并进行偏相关分析以关联体积测量和认知测量。
与对照组相比，MCI患者一致地表现出颞上回、左侧海马和内侧额顶叶区域的显著萎缩。与MCI患者相比，早期AD患者的边缘区域、颞叶新皮质和楔前叶萎缩增加。虽然各组之间在记忆保持和回忆分数上的差异与年龄和体积变量无关，但在MCI患者中观察到学习和回忆分数与海马体积之间存在显著相关性，在AD患者中观察到与颞叶新皮质体积之间存在显著相关性。颞上回和内侧新皮质区域的萎缩代表了与海马萎缩发展平行的遗忘型MCI的结构相关因素。
除了内侧颞叶萎缩外，识别遗忘型MCI患者的体积异常模式需要密切随访，以持续评估这些患者进展为早期AD的情况。
