社区老年人群深部灰质结构体积和形状的神经病理学关联
Neuropathological Correlates of Volume and Shape of Deep Gray Matter Structures in Community-Based Older Adults.
作者信息
Saifullah Khalid, Makkinejad Nazanin, Yasar Md Tahmid, Evia Arnold M, Leurgans Sue E, Bennett David A, Schneider Julie A, Arfanakis Konstantinos
机构信息
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois, USA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
出版信息
Hum Brain Mapp. 2025 Jul;46(10):e70273. doi: 10.1002/hbm.70273.
Age-related neurodegenerative and cerebrovascular neuropathologies often coexist in the brain of older adults and contribute to brain abnormalities, cognitive decline and dementia. While deep gray matter structures are implicated early and/or strongly in these processes, the independent effects of various age-related neuropathologies on these structures remain poorly understood. The goal of this study was to investigate the independent association of various age-related neuropathologies with the volume and shape of deep gray matter structures in a large number of community-based older adults that came to autopsy. Cerebral hemispheres from 842 participants of four community studies at the Rush Alzheimer's Disease Center were imaged with MRI ex vivo and underwent detailed neuropathologic examination. Linear regression was used to study the association of various neuropathologies with the volume and shape of six deep gray matter structures (hippocampus, amygdala, caudate, thalamus, nucleus accumbens, putamen) controlling for age at death, sex, years of education, scanner, and postmortem intervals. Both the volumetric and shape analyses showed independent associations of tangles with structural abnormalities in all deep brain structures, of limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) with hippocampus and amygdala, of atherosclerosis with hippocampus, and of gross infarcts with caudate (all p < 0.05 corrected for multiple comparisons). Shape analysis revealed the corresponding independent spatial patterns of inward deformation and also showed additional associations of neuropathologies with deep brain structures (p < 0.05 corrected for multiple comparisons). When analyses were repeated in left and right hemispheres separately, the results were mostly similar in both hemispheres. Mixed pathologies are very common in the older adult brain and the present comprehensive study disentangles their independent effects on multiple deep gray matter structures. These neuropathologic signatures may potentially be used in combination with other features toward in vivo prediction of neuropathologies which could have important implications in future clinical trials and the development of prevention and treatment strategies.
与年龄相关的神经退行性和脑血管神经病理学病变在老年人脑中常常并存,会导致脑结构异常、认知衰退和痴呆。虽然深部灰质结构在这些过程中早期就会受到影响和/或影响程度较大,但各种与年龄相关的神经病理学病变对这些结构的独立影响仍知之甚少。本研究的目的是在大量进行尸检的社区老年人中,调查各种与年龄相关的神经病理学病变与深部灰质结构体积和形状的独立关联。拉什阿尔茨海默病中心四项社区研究的842名参与者的大脑半球进行了离体MRI成像,并接受了详细的神经病理学检查。采用线性回归研究各种神经病理学病变与六个深部灰质结构(海马体、杏仁核、尾状核、丘脑、伏隔核、壳核)体积和形状的关联,并对死亡年龄、性别、受教育年限、扫描仪和死后间隔进行了控制。体积分析和形状分析均显示,缠结与所有深部脑结构的结构异常存在独立关联,边缘型为主的年龄相关TDP-43脑病神经病理学改变(LATE-NC)与海马体和杏仁核存在独立关联,动脉粥样硬化与海马体存在独立关联,大面积梗死与尾状核存在独立关联(所有p值经多重比较校正后均<0.05)。形状分析揭示了相应的向内变形的独立空间模式,还显示了神经病理学病变与深部脑结构的其他关联(经多重比较校正后p值<0.05)。当分别在左右半球重复进行分析时,两个半球的结果大多相似。混合病变在老年人大脑中非常常见,本综合研究阐明了它们对多个深部灰质结构的独立影响。这些神经病理学特征可能与其他特征结合起来,用于对神经病理学病变进行体内预测,这可能对未来的临床试验以及预防和治疗策略的制定具有重要意义。