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基于磁共振成像(MRI)诊断早期阿尔茨海默病时海马体、杏仁核及额叶的体积:与记忆功能的相关性

Volumes of hippocampus, amygdala and frontal lobes in the MRI-based diagnosis of early Alzheimer's disease: correlation with memory functions.

作者信息

Laakso M P, Soininen H, Partanen K, Helkala E L, Hartikainen P, Vainio P, Hallikainen M, Hänninen T, Riekkinen P J

机构信息

Department of Neurology, University Hospital, Kuopio, Finland.

出版信息

J Neural Transm Park Dis Dement Sect. 1995;9(1):73-86. doi: 10.1007/BF02252964.

Abstract

We studied the usefulness of measuring volumes of the hippocampus, amygdala and frontal lobes with coronal magnetic resonance imaging (MRI) scans in the diagnosis of early Alzheimer's disease (AD). We examined 32 patients diagnosed according to the NINCDS-ADRDA criteria of probable AD and 16 age-matched healthy cognitively normal controls. The AD patients had mild dementia with a mean score of 22.8 in the Mini-Mental Status Examination (MMSE). We used a 1.5 T magnetic resonance imager and normalized the volumes for brain area. The AD patients had significantly smaller volumes of the right and the left hippocampus (-38%) (ANOVA, p < 0.0001) and the left frontal lobe (-16%, p < 0.05) compared to controls. The reductions in volumes of the right frontal lobe (-13%), the right amygdala (-14%) or the left amygdala (-18%) were not statistically significant. In the discriminant function analysis which included the volumes of the hippocampus, amygdala, and the frontal lobes and age, the volumes of the left and right hippocampus, the left and right frontal lobe, and the right amygdala entered the model and we could correctly classify 92% of the subjects into AD and control groups (Chi-square 42.6, df 5, p < 0.001). By using the volumes of the hippocampus, the frontal lobes or the amygdala on their alone, the correct classification was achieved in 88%, 65% and 58% of the subjects, respectively. In addition, in AD patients the volumes of the left hippocampus correlated significantly with the MMSE score and with immediate and delayed verbal memory; the smaller the volume the more impaired was their performance. Our data indicate that measurements of volumes of the hippocampus might be useful in diagnosis of early AD.

摘要

我们研究了通过冠状面磁共振成像(MRI)扫描测量海马体、杏仁核和额叶体积在早期阿尔茨海默病(AD)诊断中的作用。我们检查了32例根据NINCDS-ADRDA标准诊断为可能患有AD的患者以及16名年龄匹配、认知功能正常的健康对照者。AD患者患有轻度痴呆,简易精神状态检查表(MMSE)的平均得分为22.8分。我们使用1.5T磁共振成像仪,并将体积标准化为脑区体积。与对照组相比,AD患者的右侧和左侧海马体体积显著减小(-38%)(方差分析,p<0.0001),左侧额叶体积减小(-16%,p<0.05)。右侧额叶体积减小(-13%)、右侧杏仁核体积减小(-14%)或左侧杏仁核体积减小(-18%)无统计学意义。在包括海马体、杏仁核、额叶体积和年龄的判别函数分析中,左侧和右侧海马体、左侧和右侧额叶以及右侧杏仁核的体积进入模型,我们能够将92%的受试者正确分类为AD组和对照组(卡方值42.6,自由度5,p<0.001)。单独使用海马体、额叶或杏仁核的体积时,分别有88%、65%和58%的受试者能够正确分类。此外,在AD患者中,左侧海马体的体积与MMSE评分以及即刻和延迟言语记忆显著相关;体积越小,其表现受损越严重。我们的数据表明,测量海马体体积可能有助于早期AD的诊断。

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