Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Psychiatry Clin Neurosci. 2020 Nov;74(11):587-593. doi: 10.1111/pcn.13103. Epub 2020 Jul 31.
Pineal parenchymal volume (PPV) reduction is one of the predisposing factors for Alzheimer's disease (AD). Therefore, PPV could be used as a predictor of developing AD in clinical settings. We investigated whether PPV in patients with mild cognitive impairment (MCI) was correlated with conversion of these patients to AD.
A total of 237 patients with MCI underwent brain magnetic resonance imaging. A two-sample t-test was used to compare PPV at baseline in MCI patients who converted to AD (MCI-C) with those who did not convert (MCI-NC). Logistic regression analysis with forced entry was used to identify predictors of AD, with variables of PPV, age, sex, education, APOE-ε4 alleles, Mini Mental State Examination score, and total intracranial volume at baseline. Two-way repeated-measures analysis of variance was conducted to compare PPV at baseline and at the last examination in the MCI-C and MCI-NC groups.
PPV in the MCI-C group was significantly lower than that in the MCI-NC group. In logistic regression analysis, two independent predictors of AD were identified: Mini Mental State Examination and PPV. Two-way repeated-measures analysis of variance revealed a significant group effect, but no time effect.
The pineal volume is a predictor of AD conversion, and pineal volume reduction in AD starts early when patients are still in the MCI stage. Thus, pineal volume reduction might be useful as a predictor of developing AD in clinical settings.
松果体实质体积(PPV)减少是阿尔茨海默病(AD)的一个易感因素。因此,PPV 可以作为临床预测 AD 发生的指标。我们研究了轻度认知障碍(MCI)患者的 PPV 是否与这些患者向 AD 的转化有关。
共 237 例 MCI 患者接受了脑部磁共振成像检查。采用两样本 t 检验比较了转化为 AD(MCI-C)和未转化(MCI-NC)的 MCI 患者的基线时 PPV。采用强制进入的 logistic 回归分析,以识别 AD 的预测因素,包括基线时的 PPV、年龄、性别、教育程度、APOE-ε4 等位基因、简易精神状态检查评分和总颅内体积。对 MCI-C 和 MCI-NC 组进行基线和最后一次检查时的 PPV 进行双向重复测量方差分析。
MCI-C 组的 PPV 明显低于 MCI-NC 组。logistic 回归分析发现 AD 的两个独立预测因素是简易精神状态检查和 PPV。双向重复测量方差分析显示存在显著的组间效应,但无时间效应。
松果体体积是 AD 转化的预测指标,AD 患者在仍处于 MCI 阶段时就出现松果体体积减少,这表明松果体体积减少可能有助于临床预测 AD 的发生。