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灰质萎缩和认知评估对区分 aMCI 和 naMCI 的疗效。

The efficacy of gray matter atrophy and cognitive assessment in differentiation of aMCI and naMCI.

机构信息

Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.

Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.

出版信息

Appl Neuropsychol Adult. 2022 Jan-Feb;29(1):83-89. doi: 10.1080/23279095.2019.1710509. Epub 2020 Jan 16.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) is a heterogeneous entity that can be categorized into related but different subtypes. In this study, we analyzed the gray matter structural changes of amnestic MCI (aMCI) and non-amnestic MCI (naMCI), and how it resulted in diverse cognitive impairment.

METHODS

Altogether 77 individuals were recruited, including 28 cognitively normal controls (NC), 25 naMCI subjects, and 24 aMCI subjects. All participants underwent a 3.0 T magnetic resonance (MR) scan and a detailed neuropsychological examination. Cortical thickness and subcortical nuclei volume were extracted by Freesurfer software and compared among groups. The areas with significant differences were further analyzed by general linear regression to identify the risk factors of each cognitive impairment subtypes.

RESULTS

Significant differences were observed in bilateral hippocampi, amygdala, thalamus, accumbens, left transverse temporal gyrus and left precuneus among groups. AMCI and naMCI were significantly different in the right hippocampus, bilateral amygdala, left precuneus, and left transverse temporal gyrus. Linear regression analysis revealed that the atrophy of left precuneus was a risk factor of memory, executive function (EF) and visuospatial impairment ( < 0.001). The atrophy of left amygdala, right accumbens and left thalamus were risk factors of memory, EF and language impairment respectively ( < 0.05).

CONCLUSIONS

These findings confirmed that different gray matter structural changes could lead to specific neuropsychological features in MCI subtypes. Thorough understanding of MCI subtypes and the underlying pathology would be beneficial for precise diagnosis and intervention.

摘要

背景

轻度认知障碍(MCI)是一种异质性实体,可以分为相关但不同的亚型。在这项研究中,我们分析了遗忘型 MCI(aMCI)和非遗忘型 MCI(naMCI)的灰质结构变化,以及这些变化如何导致不同的认知障碍。

方法

共招募了 77 名参与者,包括 28 名认知正常对照者(NC)、25 名 naMCI 受试者和 24 名 aMCI 受试者。所有参与者均接受了 3.0T 磁共振(MR)扫描和详细的神经心理学检查。通过 Freesurfer 软件提取皮质厚度和皮质下核体积,并在组间进行比较。对有显著差异的区域进行进一步的一般线性回归分析,以确定每个认知障碍亚型的风险因素。

结果

组间双侧海马体、杏仁核、丘脑、伏隔核、左侧横向颞叶和左侧楔前叶存在显著差异。AMCI 和 naMCI 在右侧海马体、双侧杏仁核、左侧楔前叶和左侧横向颞叶存在显著差异。线性回归分析显示,左侧楔前叶的萎缩是记忆、执行功能(EF)和视空间障碍的风险因素(<0.001)。左侧杏仁核、右侧伏隔核和左侧丘脑的萎缩分别是记忆、EF 和语言障碍的风险因素(<0.05)。

结论

这些发现证实了不同的灰质结构变化可能导致 MCI 亚型的特定神经心理学特征。深入了解 MCI 亚型及其潜在的病理学将有助于进行精确的诊断和干预。

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