Mao Chenhui, Hou Bo, Li Jie, Chu Shanshan, Huang Xinying, Wang Jie, Dong Liling, Liu Caiyan, Feng Feng, Peng Bin, Gao Jing
Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science/Peking Union Medical College, Beijing 100730, China.
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science/Peking Union Medical College, Beijing 100730, China.
Curr Alzheimer Res. 2022;19(8):618-627. doi: 10.2174/1567205019666220905145756.
Quantitative measures of atrophy on structural MRI are sensitive to the neurodegeneration that occurs in AD, and the topographical pattern of atrophy could serve as a sensitive and specific biomarker.
We aimed to examine the distribution of cortical atrophy associated with cognitive decline and disease stage based on quantitative structural MRI analysis in a Chinese cohort to inform clinical diagnosis and follow-up of AD patients.
One hundred and eleven patients who were clinically diagnosed with probable AD were enrolled. All patients completed a systemic cognitive evaluation and domain-specific batteries. The severity of cognitive decline was defined by MMSE score: 1-10 severe, 11-20 moderate, and 21-30 mild. Cortical volume and thickness determined using 3D-T1 MRI data were analyzed using voxelbased morphometry and surface-based analysis supported by the DR. Brain Platform.
The male:female ratio was 38:73. The average age was 70.8 ± 10.6 years. The mild: moderate: severe ratio was 48:38:25. Total grey matter volume was significantly related to cognition while the relationship between white matter volume and cognition did not reach statistical significance. The volume of the temporal-parietal-occipital cortex was most strongly associated with cognitive decline in group analysis, while the hippocampus and entorhinal area had a less significant association with cognitive decline. Volume of subcortical grey matter was also associated with cognition. Volume and thickness of temporoparietal cortexes were significantly correlated with the cognitive decline, with a left predominance observed.
Cognitive deterioration was associated with cortical atrophy. Volume and thickness of the left temporal-parietal-occipital cortex were most important in early diagnosis and longitudinal evaluation of AD in clinical practice. Cognitively relevant cortices were left predominant.
结构磁共振成像（MRI）上萎缩的定量测量对阿尔茨海默病（AD）中发生的神经退行性变敏感，萎缩的地形学模式可作为一种敏感且特异的生物标志物。
我们旨在基于对中国队列的定量结构MRI分析，研究与认知衰退和疾病阶段相关的皮质萎缩分布情况，为AD患者的临床诊断和随访提供依据。
纳入111例临床诊断为可能AD的患者。所有患者均完成了系统的认知评估和特定领域测试。认知衰退的严重程度由简易精神状态检查表（MMSE）评分定义：1 - 10分为重度，11 - 20分为中度，21 - 30分为轻度。使用基于体素的形态测量法和由脑博士平台支持的基于表面的分析方法，对利用三维T1 MRI数据确定的皮质体积和厚度进行分析。
男女比例为38:73。平均年龄为70.8±10.6岁。轻度:中度:重度比例为48:38:25。总灰质体积与认知显著相关，而白质体积与认知之间的关系未达到统计学意义。在组分析中，颞顶枕叶皮质的体积与认知衰退的相关性最强，而海马体和内嗅区与认知衰退的相关性较小。皮质下灰质体积也与认知相关。颞顶叶皮质的体积和厚度与认知衰退显著相关，且观察到左侧更为明显。
认知恶化与皮质萎缩相关。在临床实践中，左侧颞顶枕叶皮质的体积和厚度对AD的早期诊断和纵向评估最为重要。与认知相关的皮质以左侧为主。
