Nakajima Koji, Horii Chiaki, Kodama Hiroyasu, Shirokoshi Tomohiko, Ogawa Akitoshi, Osada Takahiro, Konishi Seiki, Oshima Yasushi, Iidaka Toshiko, Muraki Shigeyuki, Oka Hiroyuki, Kawaguchi Hiroshi, Akune Toru, Hashizume Hiroshi, Yamada Hiroshi, Yoshida Munehito, Nakamura Kozo, Shojima Masaaki, Tanaka Sakae, Yoshimura Noriko
Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Department of Neurophysiology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-Ku, Tokyo, 113-8421, Japan.
Osteoporos Int. 2025 Apr;36(4):627-636. doi: 10.1007/s00198-025-07403-6. Epub 2025 Feb 5.
Investigating vertebral fractures and brain structure, we found significant gray matter volume reductions in the right hippocampus, amygdala, and parahippocampal gyrus, especially in males. These findings emphasize the importance of integrating skeletal and neural health in osteoporosis management.
Vertebral fractures (VF) due to osteoporosis impact morbidity and quality of life in the elderly. The relationship between VF and changes in brain structure remains underexplored. This study aimed to investigate the association between VF and gray matter volume (GMV) reductions in specific brain regions and to explore potential sex differences.
Data from 1,751 participants (571 males, 1,180 females; mean age 64.9, range 18-97) in the fourth survey of the population-based Research on Osteoarthritis/Osteoporosis Against Disability study (2015-2016) were used. Participants were classified into those with and without VF (VF + and VF - groups) based on Genant's semiquantitative method, assessed by spine radiographs. Voxel-based morphometry was applied to MRI images to measure GMV, and a general linear model analysis was performed to compare GMV between groups, adjusting for age, sex, total brain volume, and Mini-Mental State Examination scores as covariates. Additionally, a two-way analysis of variance was conducted on the significant GMV cluster, with sex and VF presence as independent variables, to explore interaction effects.
The VF+ group consisted of 113 participants, while the VF- group included 1,638 participants. The analysis identified a significant cluster with reduced GMV in the VF + group compared to the VF - group. This cluster included the right hippocampus, right amygdala, and right parahippocampal gyrus. Further analysis revealed that males in the VF + group exhibited more pronounced GMV reductions in the significant cluster compared to females.
These findings suggest that VF is associated with significant reductions in brain regions critical for memory, emotional processing, and visuospatial memory, with more severe effects observed in males.
在对椎体骨折和脑结构进行研究时，我们发现右侧海马体、杏仁核和海马旁回的灰质体积显著减少，在男性中尤为明显。这些发现强调了在骨质疏松症管理中整合骨骼和神经健康的重要性。
骨质疏松导致的椎体骨折（VF）会影响老年人的发病率和生活质量。VF与脑结构变化之间的关系仍未得到充分研究。本研究旨在调查VF与特定脑区灰质体积（GMV）减少之间的关联，并探索潜在的性别差异。
使用了基于人群的骨关节炎/骨质疏松症与残疾研究第四次调查（2015 - 2016年）中1751名参与者（571名男性，1180名女性；平均年龄64.9岁，范围18 - 97岁）的数据。根据Genant半定量方法，通过脊柱X线片评估，将参与者分为有VF和无VF两组（VF+组和VF-组）。基于体素的形态测量法应用于MRI图像以测量GMV，并进行一般线性模型分析以比较两组之间的GMV，将年龄、性别、全脑体积和简易精神状态检查分数作为协变量进行调整。此外，对显著的GMV簇进行双向方差分析，将性别和VF的存在作为自变量，以探索交互作用。
VF+组有113名参与者，VF-组包括1638名参与者。分析发现，与VF-组相比，VF+组有一个GMV减少的显著簇。该簇包括右侧海马体、右侧杏仁核和右侧海马旁回。进一步分析显示，与女性相比，VF+组中的男性在显著簇中的GMV减少更为明显。
这些发现表明，VF与对记忆、情绪处理和视觉空间记忆至关重要的脑区显著减少有关，在男性中观察到的影响更为严重。
