From the Department of Neurology (A.L.C.S., R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Departments of Radiology (M.L.S., J.L.G., C.G.S. C.R.J.), Information Technology (M.L.S., J.L.G.), and Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Epidemiology (A.W., A.G., R.F.G., A.R.S.), Johns Hopkins University Bloomberg School of Public Health; Johns Hopkins University Center on Aging and Health (A.G.), Baltimore, MD; and Department of Geriatrics (T.H.M.), University of Mississippi Medical Center, Jackson.
Neurology. 2019 Mar 5;92(10):e1051-e1063. doi: 10.1212/WNL.0000000000007042. Epub 2019 Feb 6.
To evaluate the association of cognitive declines in the domains of memory, language, and executive function with brain gray matter (GM) volume in old age.
This was a prospective study of 1,846 participants in the Atherosclerosis Risk in Communities (ARIC) Study who underwent 3T brain MRI scans in 2011 to 2013. Participants were categorized by cognitive domain performance trajectory over the prior 20 years (cut point to define decline: 20th percentile). Associations between GM volume and cognitive declines were assessed at the voxel level with voxel-based morphometry and at the regional level with atlas-defined GM volumes of specific regions of interest.
Participants were an average age of 76 years; 60% were female; and 28% were black. Participants in the top 20th percentile for decline in the memory domain had smaller GM volumes in the medial temporal lobe (-3.3%, 95% confidence interval [CI] -4.6% to -2.1%), amygdala (-2.7%, 95% CI -4.1% to -1.3%), entorhinal cortex (-4.1%, 95% CI -6.0% to -2.2%), and hippocampus (-3.8%, 95% CI -5.2% to -2.4%) compared to participants who were in the lowest 80th percentile for decline in all domains. In contrast, among participants who were in the top 20th percentile for decline in the language or executive function domains, GM volumes were smaller in more brain regions.
Declines in memory function were associated with brain volume loss in the medial temporal and hippocampal formations. Declines in language and executive function were associated with decreases in brain volumes across more noncontiguous brain regions.
评估记忆、语言和执行功能领域的认知衰退与老年人大脑灰质（GM）体积之间的关系。
这是一项对 1846 名参与动脉粥样硬化风险社区（ARIC）研究的参与者的前瞻性研究，他们在 2011 年至 2013 年期间接受了 3T 脑部 MRI 扫描。参与者根据过去 20 年的认知域表现轨迹进行分类（定义下降的切点：第 20 百分位）。使用基于体素的形态计量学在体素水平上，以及使用图谱定义的特定感兴趣区域的 GM 体积在区域水平上评估 GM 体积与认知下降之间的相关性。
参与者的平均年龄为 76 岁；60%为女性；28%为黑人。在记忆域中排名前 20%的下降者的 GM 体积在中颞叶（-3.3%，95%置信区间[CI] -4.6%至-2.1%）、杏仁核（-2.7%，95% CI -4.1%至-1.3%）、内嗅皮质（-4.1%，95% CI -6.0%至-2.2%）和海马体（-3.8%，95% CI -5.2%至-2.4%）中较小，与所有域中下降率最低的 80%的参与者相比。相比之下，在语言或执行功能域中排名前 20%的下降者中，GM 体积在更多的脑区较小。
记忆功能的下降与中颞叶和海马体结构的脑容量损失有关。语言和执行功能的下降与更多非连续脑区的脑容量减少有关。
