Lu Qingzheng, Wang Yu, Qu Bingqian, Wang Caixia, Su Xiao, Wang Siqi, Xing Yi, Qin Wen, Tang Yi, Zhang Nan
Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China.
CNS Neurosci Ther. 2024 Dec;30(12):e70194. doi: 10.1111/cns.70194.
The nucleus basalis of Meynert (NBM) is a major source of cholinergic innervation in the central nervous system. We aimed to investigate the characteristics of structural and functional alterations in the NBM and its projections in patients with mild cognitive impairment (MCI) and the effects of computerized cognitive training (CCT).
Forty-five patients with MCI and 45 cognitively unimpaired controls (CUCs) were recruited. NBM volume, mean diffusivity (MD) of NBM white matter (WM) projections, and functional connectivity (FC) of projections of the NBM were measured with T1-weighted imaging, diffusion tensor imaging (DTI), and resting-state functional magnetic resonance imaging (rs-fMRI). Thirty-six MCI patients were randomly assigned to receive CCT or control training. The effects of CCT on the neuropsychological measures and MRI properties were analyzed with a linear mixed model (LMM).
We detected that compared with the CUCs, the MCI patients had a reduced volume of the NBM and a greater MD of both cholinergic pathways. Increased MD values of both pathways were related to lower scores of global cognition, processing speed and attention in all participants. After CCT intervention, significant group × timepoint effects on score of the Backward Digit Span and the FC between NBM and right putamen were observed in the CCT group compared to the control group.
NBM atrophy and WM pathway disruption occurred in MCI patients and were correlated with cognitive impairment. Working memory and the FC between NBM and right putamen could be improved by cognitive training.
梅纳特基底核（NBM）是中枢神经系统胆碱能神经支配的主要来源。我们旨在研究轻度认知障碍（MCI）患者中NBM及其投射的结构和功能改变特征以及计算机化认知训练（CCT）的效果。
招募了45例MCI患者和45例认知未受损对照者（CUC）。采用T1加权成像、扩散张量成像（DTI）和静息态功能磁共振成像（rs-fMRI）测量NBM体积、NBM白质（WM）投射的平均扩散率（MD）以及NBM投射的功能连接性（FC）。36例MCI患者被随机分配接受CCT或对照训练。采用线性混合模型（LMM）分析CCT对神经心理学测量和MRI特性的影响。
我们检测到，与CUC相比，MCI患者的NBM体积减小，两条胆碱能通路的MD均增大。两条通路MD值的增加与所有参与者的整体认知、处理速度和注意力得分较低有关。CCT干预后，与对照组相比，CCT组在倒背数字广度得分以及NBM与右侧壳核之间的FC方面观察到显著的组×时间点效应。
MCI患者发生了NBM萎缩和WM通路破坏，且与认知障碍相关。认知训练可改善工作记忆以及NBM与右侧壳核之间的FC。
