Meng Huaxing, Liu Bo, Lu Xiaoting, Tan Yan, Wang Shanshan, Pan Baolong, Zhang Hui, Niu Qiao
Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China.
College of Medical Imaging, Shanxi Medical University, Taiyuan, China.
Front Neurol. 2025 Jan 7;15:1500924. doi: 10.3389/fneur.2024.1500924. eCollection 2024.
Cognitive impairment (CI) is a condition in which an individual experiences noticeable impairment in thinking abilities. Long-term exposure to aluminum (Al) can cause CI. This study aimed to determine the relationship between CI and MRI-related changes in postroom workers exposed to Al.
Thirty patients with CI and 25 healthy controls were recruited. Plasma aluminum levels were measured using inductively coupled plasma-mass spectrometry. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and an auditory-verbal learning test (AVLT). All participants underwent magnetic resonance imaging scans. 3D T1-weighted anatomical images and resting-state functional magnetic resonance imaging data were acquired, and voxel-based morphometry and ROI-based FC were used for analysis. A mediation analysis was also conducted.
Plasma aluminum levels were significantly higher in the CI group than in the normal control group. The gray matter (GM) volume in the left caudate and bilateral hippocampus was lower in the CI group and was positively correlated with cognitive scale scores. There was no significant difference in functional connectivity (FC) between the left caudate and the whole brain between the two groups. Significant alterations in hippocampal FC were observed in certain brain areas, mainly in the left cerebellar vermis, left middle frontal gyrus (BA9), and right superior frontal gyrus relative to the supplementary motor area (BA6). The FC coefficients were also associated with cognitive scale scores. Furthermore, plasma Al concentration was negatively correlated with the Montreal Cognitive Assessment score, bilateral hippocampal GM volume, and FC coefficient between the left hippocampus and left cerebellar vermis. Mediation analysis showed GM alteration of left caudate and bilateral hippocampus and FC alteration of left hippocampus to left cerebellar vermis could explained 19.80-32.07% of the effect of MoCA scores change related to Al exposure, besides the GM alteration of right hippocampus acted as indirect mediator (68.75%) of the association between Al and AVLT delayed recall scores.
Our data indicates that alterations in the structure and function of special brain domain, especially the hippocampus, are associated with Al-induced CI. These brain regions can partly explain the effect of Al on cognitive impairment.
认知障碍（CI）是一种个体思维能力出现明显损害的病症。长期接触铝（Al）可导致认知障碍。本研究旨在确定接触铝的机房工作人员的认知障碍与磁共振成像（MRI）相关变化之间的关系。
招募了30例认知障碍患者和25名健康对照者。使用电感耦合等离子体质谱法测量血浆铝水平。使用蒙特利尔认知评估量表（MoCA）和听觉言语学习测试（AVLT）评估认知功能。所有参与者均接受磁共振成像扫描。采集三维T1加权解剖图像和静息态功能磁共振成像数据，并采用基于体素的形态学测量和基于感兴趣区（ROI）的功能连接（FC）进行分析。还进行了中介分析。
认知障碍组的血浆铝水平显著高于正常对照组。认知障碍组左侧尾状核和双侧海马的灰质（GM）体积较低，且与认知量表评分呈正相关。两组之间左侧尾状核与全脑的功能连接（FC）无显著差异。在某些脑区观察到海马FC有显著改变，主要是相对于辅助运动区（BA6）的左侧小脑蚓部、左侧额中回（BA9）和右侧额上回。FC系数也与认知量表评分相关。此外，血浆铝浓度与蒙特利尔认知评估量表评分、双侧海马GM体积以及左侧海马与左侧小脑蚓部之间的FC系数呈负相关。中介分析表明，左侧尾状核和双侧海马的GM改变以及左侧海马至左侧小脑蚓部的FC改变可解释与铝暴露相关的MoCA评分变化效应的19.80 - 32.07%，此外，右侧海马的GM改变是铝与AVLT延迟回忆评分之间关联的间接中介（68.75%）。
我们的数据表明，特定脑区尤其是海马的结构和功能改变与铝诱导的认知障碍有关。这些脑区可部分解释铝对认知障碍的影响。
