卒中后痴呆患者海马亚区萎缩模式。

Atrophic Pattern of Hippocampal Subfields in Post-Stroke Demented Patient.

机构信息

Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China.

Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.

出版信息

J Alzheimers Dis. 2021;80(3):1299-1309. doi: 10.3233/JAD-200804.

DOI:10.3233/JAD-200804

PMID:33646148

Abstract

BACKGROUND

Previous studies have demonstrated that hippocampal atrophy is a hallmark of dementia and can be used to predict the outcome of post-stroke demented (PSD) patients. The hippocampus consists of several subfields but their involvement in the pathophysiology of the PSD remains unclear.

OBJECTIVE

The present study aimed to investigate volumetric alterations of hippocampal subfields in patients with PSD.

METHODS

High-resolution T1-weighted images were collected from 27 PSD and 28 post-stroke nondemented (PSND) patients who recovered from ischemic stroke, and 17 age-matched normal control (NC). We estimated the volumes of the hippocampal subfields using FreeSurfer 6.0 which segmented the hippocampus into 12 subfields in each hemisphere. The volumetric differences between the groups were evaluated by the two-sample tests after regressing out the age, sex, education, and total intracranial volume.

RESULTS

Compared with NC group, PSD group showed smaller volumes in the entire hippocampus and its subfields, and such differences were not found in PSND group. Moreover, we found the dementia-specific atrophy in the left granule cell layer of dentate gyrus (GC-DG) and CA4 in the PSD patients compared with NC and PSND. Regression analysis showed positive correlations between the changes of cognitive performance and the asymmetry index in the CA3/4 and GC-DG of the PSD group. Furthermore, we found that the volumes of hippocampal subfields provided a better classification performance than the entire hippocampus.

CONCLUSION

Our findings suggest that the hippocampus is reduced in the PSD patients and it presents a selective subfield involvement.

摘要

背景

先前的研究表明，海马萎缩是痴呆症的一个标志，可以用于预测卒中后痴呆（PSD）患者的预后。海马由几个亚区组成，但它们在 PSD 的病理生理学中的参与程度尚不清楚。

目的

本研究旨在探讨 PSD 患者海马亚区体积改变。

方法

从 27 例 PSD 和 28 例从缺血性卒中恢复的卒中后非痴呆（PSND）患者以及 17 名年龄匹配的正常对照（NC）中采集高分辨率 T1 加权图像。我们使用 FreeSurfer 6.0 估计海马亚区的体积，该软件将海马在每个半球分为 12 个亚区。通过回归年龄、性别、教育程度和总颅内体积后，用两样本检验评估组间的体积差异。

结果

与 NC 组相比，PSD 组整个海马及其亚区的体积较小，而 PSND 组则没有差异。此外，我们发现 PSD 患者左齿状回颗粒细胞层（GC-DG）和 CA4 存在与 NC 和 PSND 患者相比的痴呆特异性萎缩。回归分析显示 PSD 组认知表现的变化与 CA3/4 和 GC-DG 的不对称指数呈正相关。此外，我们发现海马亚区的体积比整个海马提供了更好的分类性能。