McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Hum Brain Mapp. 2023 Jun 1;44(8):3147-3157. doi: 10.1002/hbm.26269. Epub 2023 Mar 20.
Hippocampal changes are associated with increased age and cognitive decline due to mild cognitive impairment (MCI) and Alzheimer's disease (AD). These associations are often observed only in the later stages of decline. This study examined if hippocampal grading, a method measuring local morphological similarity of the hippocampus to cognitively normal controls (NCs) and AD participants, is associated with cognition in NCs, subjective cognitive decline (SCD), early (eMCI), late (lMCI), and AD. A total of 1620 Alzheimer's Disease Neuroimaging Initiative participants were examined (495 NC, 262 eMCI, 545 lMCI, and 318 AD) because they had baseline MRIs and Alzheimer's disease Assessment Scale (ADAS-13) and Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. In a sub-analysis, NCs with episodic memory scores (as measured by Rey Auditory Verbal Learning Test, RAVLT) were divided into those with subjective cognitive decline (SCD+; 103) and those without (SCD-; 390). Linear regressions evaluated the influence of hippocampal grading on cognition in preclinical and prodromal AD. Lower global cognition, as measured by increased ADAS-13, was associated with hippocampal grading: NC (p < .001), eMCI (p < .05), lMCI (p < .05), and AD (p = .01). Lower global cognition as measured increased CDR-SB was associated with hippocampal grading in lMCI (p < .05) and AD (p < .001). Lower RAVLT performance was associated with hippocampal grading in SCD- (p < .05) and SCD+ (p < .05). These findings suggest that hippocampal grading is associated with global cognition in NC, eMCI, lMCI, and AD. Early changes in episodic memory during pre-clinical AD are associated with changes in hippocampal grading. Hippocampal grading may be sensitive to progressive changes early in the disease course.
海马体的变化与年龄的增长和轻度认知障碍 (MCI) 和阿尔茨海默病 (AD) 导致的认知能力下降有关。这些关联通常仅在下降的后期阶段观察到。本研究检查了海马体分级，一种测量海马体与认知正常对照 (NC) 和 AD 参与者局部形态相似性的方法，是否与 NC 中的认知、主观认知下降 (SCD)、早期 (eMCI)、晚期 (lMCI) 和 AD 相关。共检查了 1620 名阿尔茨海默病神经影像学倡议参与者（495 名 NC、262 名 eMCI、545 名 lMCI 和 318 名 AD），因为他们有基线 MRI 和阿尔茨海默病评估量表 (ADAS-13) 和临床痴呆评定量表-总和分 (CDR-SB) 评分。在一项亚分析中，将 episodic memory 评分（通过 Rey 听觉言语学习测试，RAVLT 测量）的 NC 分为有主观认知下降 (SCD+；103 人) 和无主观认知下降 (SCD-；390 人)。线性回归评估了海马体分级对临床前和前驱 AD 认知的影响。ADAS-13 评分升高，表明整体认知能力下降，与海马体分级相关：NC（p<0.001）、eMCI（p<0.05）、lMCI（p<0.05）和 AD（p=0.01）。CDR-SB 评分升高表明整体认知能力下降，与 lMCI（p<0.05）和 AD（p<0.001）的海马体分级相关。RAVLT 表现与 SCD-（p<0.05）和 SCD+（p<0.05）的海马体分级相关。这些发现表明，海马体分级与 NC、eMCI、lMCI 和 AD 的整体认知能力相关。在临床前 AD 期间，情节记忆的早期变化与海马体分级的变化相关。海马体分级可能对疾病早期的进行性变化敏感。
