Gwangju Alzheimer's & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea.
Department of Biomedical Science, Chosun University, Gwangju, South Korea.
PLoS One. 2022 Nov 3;17(11):e0275233. doi: 10.1371/journal.pone.0275233. eCollection 2022.
The diagnosis of Alzheimer's disease (AD) needs to be improved. We investigated if hippocampal subfield volume measured by structural imaging, could supply information, so that the diagnosis of AD could be improved. In this study, subjects were classified based on clinical, neuropsychological, and amyloid positivity or negativity using PET scans. Data from 478 elderly Korean subjects grouped as cognitively unimpaired β-amyloid-negative (NC), cognitively unimpaired β-amyloid-positive (aAD), mild cognitively impaired β-amyloid-positive (pAD), mild cognitively impaired-specific variations not due to dementia β-amyloid-negative (CIND), severe cognitive impairment β-amyloid-positive (ADD+) and severe cognitive impairment β-amyloid-negative (ADD-) were used. NC and aAD groups did not show significant volume differences in any subfields. The CIND did not show significant volume differences when compared with either the NC or the aAD (except L-HATA). However, pAD showed significant volume differences in Sub, PrS, ML, Tail, GCMLDG, CA1, CA4, HATA, and CA3 when compared with the NC and aAD. The pAD group also showed significant differences in the hippocampal tail, CA1, CA4, molecular layer, granule cells/molecular layer/dentate gyrus, and CA3 when compared with the CIND group. The ADD- group had significantly larger volumes than the ADD+ group in the bilateral tail, SUB, PrS, and left ML. The results suggest that early amyloid depositions in cognitive normal stages are not accompanied by significant bilateral subfield volume atrophy. There might be intense and accelerated subfield volume atrophy in the later stages associated with the cognitive impairment in the pAD stage, which subsequently could drive the progression to AD dementia. Early subfield volume atrophy associated with the β-amyloid burden may be characterized by more symmetrical atrophy in CA regions than in other subfields. We conclude that the hippocampal subfield volumetric differences from structural imaging show promise for improving the diagnosis of Alzheimer's disease.
阿尔茨海默病（AD）的诊断需要改进。我们研究了结构成像测量的海马亚区体积是否可以提供信息，从而改善 AD 的诊断。在这项研究中，根据临床、神经心理学和淀粉样蛋白阳性或阴性，使用 PET 扫描对受试者进行分类。这项研究共纳入 478 名韩国老年人，根据认知状态分为认知正常淀粉样蛋白阴性（NC）、认知正常淀粉样蛋白阳性（aAD）、轻度认知障碍淀粉样蛋白阳性（pAD）、非痴呆性轻度认知障碍淀粉样蛋白阴性（CIND）、重度认知障碍淀粉样蛋白阳性（ADD+）和重度认知障碍淀粉样蛋白阴性（ADD-）。NC 和 aAD 组在任何亚区均无显著体积差异。与 NC 或 aAD 相比，CIND 组在 L-HATA 亚区没有显著体积差异。然而，与 NC 和 aAD 相比，pAD 组在 Sub、PrS、ML、Tail、GCMLDG、CA1、CA4、HATA 和 CA3 亚区有显著体积差异。与 CIND 组相比，pAD 组在海马尾部、CA1、CA4、分子层、颗粒细胞/分子层/齿状回和 CA3 亚区也有显著差异。与 ADD+组相比，ADD-组双侧尾部、SUB、PrS 和左侧 ML 体积更大。双侧尾部、SUB、PrS 和左侧 ML 的体积更大。结果表明，在认知正常阶段，早期淀粉样蛋白沉积并不伴有明显的双侧亚区体积萎缩。在 pAD 阶段，认知障碍相关的亚区体积可能会出现强烈而加速的萎缩，随后可能会导致 AD 痴呆的进展。与β-淀粉样蛋白负荷相关的早期亚区体积萎缩可能表现为 CA 区比其他亚区更对称的萎缩。我们的结论是，结构成像的海马亚区体积差异有望改善阿尔茨海默病的诊断。
