Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Medical Science and Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Eur J Neurol. 2021 May;28(5):1520-1527. doi: 10.1111/ene.14770. Epub 2021 Feb 26.
As part of network-specific neurodegeneration, changes in cerebellar gray matter (GM) volume and impaired cerebello-cerebral functional networks have been reported in Alzheimer disease (AD). Compared with healthy controls, a volume loss in the cerebellum has been observed in patients with continuum of AD. However, little is known about the anatomical or functional changes in patients with clinical AD but no brain amyloidosis. We aimed to identify the relationship between cerebellar volume and dementia conversion of amyloid-negative mild cognitive impairment (MCI).
This study was a retrospective cohort study of patients over the age 50 years with amyloid-negative amnestic MCI who visited the memory clinic of Asan Medical Center with no less than a 36-month follow-up period. All subjects underwent detailed neuropsychological tests, 3 T brain magnetic resonance imaging scans including three-dimensional T1 imaging, and fluorine-18[F ]-florbetaben amyloid positron emission tomography scans. A spatially unbiased atlas template of the cerebellum and brainstem was used for analyzing cerebellar GM volume.
During the 36 months of follow-up, 39 of 107 (36.4%) patients converted to dementia from amnestic MCI. The converter group had more severe impairments in all visual memory tasks. In terms of volumetric analysis, reduced crus I/II volume adjusted with total intracranial volume, and age was observed in the converter group.
Significant cerebellar GM atrophy involving the bilateral crus I/II may be a novel imaging biomarker for predicting dementia progression in amyloid-negative amnestic MCI patients.
作为网络特异性神经退行性变的一部分，阿尔茨海默病（AD）患者的小脑灰质（GM）体积变化和小脑-大脑功能网络受损已被报道。与健康对照组相比，AD 连续体患者的小脑体积已经观察到损失。然而，对于临床 AD 但无脑淀粉样蛋白沉积的患者，其小脑解剖或功能变化知之甚少。我们旨在确定小脑体积与淀粉样阴性轻度认知障碍（MCI）患者向痴呆转化的关系。
这是一项回顾性队列研究，纳入了年龄在 50 岁以上、无淀粉样蛋白阴性遗忘型 MCI 且在 36 个月以上随访期内到 Asan 医疗中心记忆诊所就诊的患者。所有患者均接受了详细的神经心理学测试、3T 脑磁共振成像扫描（包括三维 T1 成像）和氟-18[F] -氟比他滨淀粉样蛋白正电子发射断层扫描。使用小脑和脑干的无偏空间图谱模板来分析小脑 GM 体积。
在 36 个月的随访期间，107 例患者中有 39 例（36.4%）从遗忘型 MCI 转化为痴呆。转化组在所有视觉记忆任务中均有更严重的损伤。在体积分析方面，校正全脑容量后，转化组的小脑 I/II 部 crus 体积减少，且与年龄有关。
双侧小脑 I/II 区 GM 萎缩可能是淀粉样阴性遗忘型 MCI 患者预测痴呆进展的新影像学生物标志物。
