Department of Psychiatry, Pusan National University School of Medicine, Busan, South Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Psychogeriatrics. 2019 Mar;19(2):105-110. doi: 10.1111/psyg.12369. Epub 2018 Nov 14.
The purpose of this study was to determine whether regionally distributed medial temporal cortex thickness (or hippocampal volume) and frontal lobe volume are independently associated with the onset of Alzheimer's disease (AD) with psychosis.
We identified 26 AD patients with psychosis (AD+P) and 48 AD patients without psychosis (AD-P) from the Memory Impairment Clinic at Pusan National University Hospital in South Korea. They were matched for age, gender, duration of AD, and Clinical Dementia Rating sum of box score. All participants met the National Institute of Neurological and Communication Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria for probable AD. Psychosis was diagnosed according to Jeste and Finkel's proposed diagnostic criteria for psychosis of AD. All participants underwent 3-T magnetic resonance imaging, and 3-D magnetization-prepared rapid gradient echo sequence was acquired for each. The FreeSurfer version 5.1 software package was used to analyze cortical thickness and volume on 3-D T -weighted images. anova was used to investigate the differences in cortical thickness and the volume of the total frontal cortex, total temporal cortex, and subregions of the medial temporal cortex between groups after age, gender, years of education, Clinical Dementia Rating sum of box score, duration of AD, and total intracranial volume were controlled for. Furthermore, we added the total frontal volume as an additional variable to investigate whether the association between the medial temporal cortex and AD+P is independent of the frontal cortex.
We found that both left and right hippocampal volume were smaller in AD+P than in AD-P. In particular, there was a significant difference in right hippocampal volume between the AD+P and AD-P groups after total frontal volume was added as an additional variable.
We found that more severe hippocampal atrophy is associated with AD+P than with AD-P. In addition, atrophy of the right hippocampus remained significant among AD+P after adjustment for frontal volume. These findings suggest that right hippocampal atrophy is independently associated with AD+P.
本研究旨在确定区域性分布的内侧颞叶皮层厚度（或海马体积）和额叶体积是否与伴有精神病症状的阿尔茨海默病（AD）的发病独立相关。
我们从韩国釜山国立大学医院的记忆障碍诊所中确定了 26 例伴有精神病症状的 AD 患者（AD+P）和 48 例不伴有精神病症状的 AD 患者（AD-P）。他们按年龄、性别、AD 病程和临床痴呆评定量表总评分箱式评分进行匹配。所有参与者均符合美国国立神经病学和中风研究所以及阿尔茨海默病和相关疾病协会的可能 AD 标准。精神病根据 Jeste 和 Finkel 提出的 AD 精神病诊断标准进行诊断。所有参与者均接受了 3-T 磁共振成像检查，并获取了 3-D 磁化准备快速梯度回波序列。使用 FreeSurfer 版本 5.1 软件包分析 3-D T1 加权图像上的皮质厚度和体积。在控制年龄、性别、受教育年限、临床痴呆评定量表总评分箱式评分、AD 病程和总颅内体积后，采用方差分析比较组间皮质厚度和总额皮质、总颞叶皮质和内侧颞叶皮质各亚区的体积差异。此外，我们添加了总额皮质作为额外变量，以研究内侧颞叶与 AD+P 之间的关联是否独立于额叶皮质。
我们发现 AD+P 的左侧和右侧海马体积均小于 AD-P。特别是，在添加总额皮质作为额外变量后，AD+P 和 AD-P 组之间的右侧海马体积存在显著差异。
我们发现与 AD-P 相比，更严重的海马萎缩与 AD+P 相关。此外，在调整额叶体积后，AD+P 中右侧海马萎缩仍然显著。这些发现表明右侧海马萎缩与 AD+P 独立相关。
