阿尔茨海默病和路易体相关认知障碍中的嗅觉功能障碍。

Olfactory dysfunction in Alzheimer's disease- and Lewy body-related cognitive impairment.

机构信息

Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.

出版信息

Alzheimers Dement. 2018 Oct;14(10):1243-1252. doi: 10.1016/j.jalz.2018.05.010. Epub 2018 Jun 21.

DOI:10.1016/j.jalz.2018.05.010

PMID:29936148

Abstract

INTRODUCTION

Olfactory dysfunction is common in Alzheimer's disease- and Lewy body-related disorders, but its neural correlates have not been clearly elucidated.

METHODS

We retrospectively recruited 237 patients with Alzheimer's disease-related cognitive impairment (ADCI) and 217 with Lewy body-related cognitive impairment (LBCI). They were identically evaluated using the Cross-Cultural Smell Identification Test, neuropsychological tests, and brain magnetic resonance imaging.

RESULTS

LBCI had more severe olfactory dysfunction than ADCI. Patients with more severe cognitive dysfunction had worse olfactory function in both groups. In ADCI, lower Cross-Cultural Smell Identification Test scores correlated with a lower cortical thickness in brain regions typically affected in Alzheimer's disease, most prominently in the right parahippocampal cortex, whereas in LBCI, the scores correlated with white matter abnormalities in regions vulnerable to Lewy body, including subcortical regions of the orbitofrontal and frontoparietal cortices.

DISCUSSION

Our results suggest that cortical atrophy in ADCI and white matter abnormalities in LBCI play important roles in olfactory dysfunction.

摘要

简介

嗅觉功能障碍在阿尔茨海默病和路易体相关疾病中很常见，但其神经相关性尚不清楚。

方法

我们回顾性招募了 237 名阿尔茨海默病相关认知障碍（ADCI）患者和 217 名路易体相关认知障碍（LBCI）患者。他们使用跨文化嗅觉识别测试、神经心理学测试和脑磁共振成像进行了相同的评估。

结果

LBCI 的嗅觉功能障碍比 ADCI 更严重。两组患者认知功能障碍越严重，嗅觉功能越差。在 ADCI 中，较低的跨文化嗅觉识别测试评分与大脑中受阿尔茨海默病影响的典型区域（最显著的是右侧海马旁皮质）的皮质厚度降低相关，而在 LBCI 中，评分与易受路易体影响的白质异常相关，包括眶额和额顶皮质的皮质下区域。