路易体轻度认知损害患者脑基底核内的 Meynert 核退化。
In vivo nucleus basalis of Meynert degeneration in mild cognitive impairment with Lewy bodies.
机构信息
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
出版信息
Neuroimage Clin. 2021;30:102604. doi: 10.1016/j.nicl.2021.102604. Epub 2021 Mar 4.
OBJECTIVES
To investigate in vivo degeneration of the cholinergic system in mild cognitive impairment with Lewy bodies (MCI-LB), we studied nucleus basalis of Meynert (NBM) volumes from structural MR images and its relation to EEG slowing and cognitive impairment.
METHODS
We studied the NBM using structural MR images in 37 patients with MCI-LB, 34 patients with MCI with Alzheimer's disease (MCI-AD), and 31 healthy control participants. We also tested correlations between NBM volumes and measures of overall cognition and measures of EEG slowing in the MCI groups.
RESULTS
Overall NBM volume was reduced in MCI-LB compared to controls with no significant difference between MCI-AD and controls or between the two MCI groups. The voxel-wise analysis revealed bilateral clusters of reduced NBM volume in MCI-LB compared to controls and smaller clusters in MCI-AD compared to controls. There was a significant association between overall NBM volume and measures of overall cognition in MCI-LB, but not in MCI-AD. In both MCI groups, reduced NBM volume was correlated with more severe EEG slowing.
CONCLUSIONS
This study provides in vivo evidence that early cholinergic degeneration in DLB occurs at the MCI stage and is related to the severity of cognitive impairment. Furthermore, the results suggest that early EEG slowing in MCI-LB might be in part cholinergically driven. Importantly, these findings suggest an early cholinergic deficit in MCI-LB that may motivate further testing of the effectiveness of cholinesterase inhibitors in this group.
目的
通过研究路易体轻度认知障碍（MCI-LB）患者活体胆碱能系统的退化情况，我们研究了基底核复合体（NBM）的体积与脑电图（EEG）减慢和认知障碍的关系。
方法
我们使用结构磁共振成像（MRI）研究了 37 例 MCI-LB 患者、34 例 MCI 合并阿尔茨海默病（MCI-AD）患者和 31 名健康对照者的 NBM。我们还测试了 MCI 组 NBM 体积与整体认知测量值和 EEG 减慢测量值之间的相关性。
结果
与对照组相比，MCI-LB 患者的总体 NBM 体积减少，而 MCI-AD 与对照组之间或两个 MCI 组之间无显著差异。体素分析显示，与对照组相比，MCI-LB 患者双侧 NBM 体积减少，MCI-AD 患者 NBM 体积减少的簇较小。MCI-LB 患者的整体 NBM 体积与整体认知测量值呈显著相关性，但 MCI-AD 患者无此相关性。在两个 MCI 组中，NBM 体积减少与 EEG 减慢程度更严重相关。
结论
本研究提供了体内证据，表明 DLB 患者的早期胆碱能退行性变发生在 MCI 阶段，与认知障碍的严重程度有关。此外，结果表明，MCI-LB 患者早期 EEG 减慢可能部分是胆碱能驱动的。重要的是，这些发现提示 MCI-LB 患者存在早期胆碱能缺陷，这可能促使进一步测试该组患者使用胆碱酯酶抑制剂的有效性。
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