Shang Song'an, Wu Jingtao, Chen Yu-Chen, Chen Hongri, Zhang Hongying, Dou Weiqiang, Wang Peng, Cao Xin, Yin Xindao
Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China.
Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Quant Imaging Med Surg. 2021 Jul;11(7):3082-3097. doi: 10.21037/qims-20-1259.
Mild cognitive impairment (MCI) has been defined as the prodromal stage of Alzheimer's disease and Parkinson's disease (PD) with dementia. We investigated the differences in regional perfusion properties among MCI subtypes and healthy control (HC) subjects by using arterial spin labeling (ASL).
Regional normalized CBF (z-CBF) and CBF-connectivity were analyzed from ASL data in 44 amnestic MCI (aMCI) patients, 42 PD-MCI patients, and 50 matched HC participants. The correlations between these significant regions and clinical performance were investigated separately using Spearman correlation analysis. Receiver operating characteristic analysis was generated to determine the differentiating ability of z-CBF values. z-CBF values in disease-related specific regions were extracted for group comparison.
MCI subgroups showed overlapped impaired regions, aMCI group seemed more extensive than the PD-MCI group. PD-MCI patients had reduced z-CBF in the bilateral putamen, left precentral gyrus, left middle cingulate gyrus, and right middle frontal gyrus compared to aMCI group. Correlations to executive performance and motor severity were found in PD-MCI group, and correlations were to memory performance found in aMCI group. CBF-connectivity in left precentral gyrus, left middle cingulate gyrus, and right middle frontal gyrus were significantly altered. All of the significant clusters had good discriminatory ability.
Normalized CBF as measured by ASL revealed different patterns of perfusion between aMCI and PD-MCI, which were probably linked to distinct neural mechanisms. The present study indicates that z-CBF can provide specific perfusion information for further pathological and neuropsychological studies.
轻度认知障碍(MCI)被定义为阿尔茨海默病和帕金森病(PD)伴发痴呆的前驱阶段。我们通过动脉自旋标记(ASL)研究了MCI各亚型与健康对照(HC)受试者之间区域灌注特性的差异。
对44例遗忘型MCI(aMCI)患者、42例PD-MCI患者和50例匹配的HC参与者的ASL数据进行区域标准化脑血流量(z-CBF)和CBF连通性分析。使用Spearman相关分析分别研究这些显著区域与临床表现之间的相关性。生成受试者工作特征分析以确定z-CBF值的鉴别能力。提取疾病相关特定区域的z-CBF值进行组间比较。
MCI亚组显示出重叠的受损区域,aMCI组似乎比PD-MCI组更广泛。与aMCI组相比,PD-MCI患者双侧壳核、左侧中央前回、左侧扣带回中部和右侧额中回的z-CBF降低。在PD-MCI组中发现与执行能力和运动严重程度相关,在aMCI组中发现与记忆能力相关。左侧中央前回、左侧扣带回中部和右侧额中回的CBF连通性显著改变。所有显著簇均具有良好的鉴别能力。
ASL测量的标准化CBF显示aMCI和PD-MCI之间存在不同的灌注模式,这可能与不同的神经机制有关。本研究表明,z-CBF可为进一步的病理和神经心理学研究提供特定的灌注信息。