The Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
The Johns Hopkins Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
Int Psychogeriatr. 2021 Mar;33(3):233-244. doi: 10.1017/S1041610220000113. Epub 2020 Feb 28.
To examine the interaction between structural brain volume measures derived from a clinical magnetic resonance imaging (MRI) and occurrence of neuropsychiatric symptoms (NPS) in outpatient memory clinic patients.
Clinical and neuroimaging data were collected from the medical records of outpatient memory clinic patients who were seen by neurologists, geriatric neuropsychiatrists, and geriatricians. MRI scan acquisition was carried out on a 3 T Siemens Verio scanner at Johns Hopkins Bayview Medical Center. Image analyses used an automated multi-label atlas fusion method with a geriatric atlas inventory to generate 193 anatomical regions from which volumes were measured. Regions of interest were generated a priori based on previous literature review of NPS in dementia. Regional volumes for agitation, apathy, and delusions were carried forward in a linear regression analysis.
Seventy-two patients had clinical and usable neuroimaging data that were analyzed and grouped by Mini-Mental State Exam (MMSE). Neuropsychiatric Inventory Questionnaire (NPI-Q) agitation was inversely associated with rostral anterior cingulate cortex (ACC) bilaterally and left subcallosal ACC volumes in the moderate severity group. Delusions were positively associated with left ACC volumes in both severe and mild groups but inversely associated with the right dorsolateral prefrontal cortex (DLPFC) in the moderate subgroup.
Agitation, apathy, and delusions are associated with volumes of a priori selected brain regions using clinical data and clinically acquired MRI scans. The ACC is an anatomic region common to these symptoms, particularly agitation and delusions, which closely mirror the findings of research-quality studies and suggest its importance as a behavioral hub.
研究门诊记忆诊所患者的结构脑体积测量值与神经精神症状（NPS）发生之间的相互作用。
从神经科医生、老年神经精神病学家和老年病医生接诊的门诊记忆诊所患者的病历中收集临床和神经影像学数据。MRI 扫描在约翰霍普金斯湾景医疗中心的 3T 西门子 Verio 扫描仪上进行。图像分析采用了一种自动化多标签图谱融合方法，结合老年图谱清单，从 193 个解剖区域生成体积测量值。根据先前痴呆症 NPS 的文献综述，生成了预先确定的感兴趣区域。在线性回归分析中，对激动、淡漠和妄想的区域体积进行了推进。
72 名患者具有可分析的临床和可用神经影像学数据，并根据 Mini-Mental State Exam（MMSE）进行分组。神经精神病学问卷（NPI-Q）激动与中度严重组双侧额前扣带皮质（ACC）和左侧胼胝体下扣带皮质的体积呈负相关。妄想与严重和轻度组的左 ACC 体积呈正相关，但与中度亚组的右侧背外侧前额叶皮质（DLPFC）呈负相关。
使用临床数据和临床采集的 MRI 扫描，对预先选择的大脑区域的体积进行了激动、淡漠和妄想的分析。ACC 是这些症状共有的解剖区域，特别是激动和妄想，这与高质量研究的发现非常吻合，表明其作为行为枢纽的重要性。
