Shear P K, Sullivan E V, Mathalon D H, Lim K O, Davis L F, Yesavage J A, Tinklenberg J R, Pfefferbaum A
Department of Psychiatry and Behavioral Sciences, Stanford (Calif) University School of Medicine, USA.
Arch Neurol. 1995 Apr;52(4):392-402. doi: 10.1001/archneur.1995.00540280078021.
This study used a semiautomated image analysis technique to quantify the rate and regional pattern of cerebrospinal fluid (CSF) volume changes in the computed tomographic brain examinations of healthy adults and patients with Alzheimer's disease (AD).
Longitudinal, within-subject design, with statistical correction for longitudinal method error (eg, head repositioning effects).
Palo Alto (Calif) Department of Veterans Affairs Medical Center.
The 41 patients with AD were recruited from the Geriatric Psychiatry Research Unit and the National Institute of Mental Health Clinical Research Center of the Palo Alto Department of Veterans Affairs Medical Center. The 35 healthy control subjects were recruited from the local community.
Cerebrospinal fluid volumes estimated from computed tomographic scans.
Even after accounting for an estimate of method error (eg, head positioning effects) across computed tomographic examinations, the patients with AD showed greater annual CSF volume increases than did the control group. This CSF volume enlargement was not uniform across brain regions of interest; rather, the patients with AD showed disproportionate volume increases in the ventricular system and the sylvian fissures. Greater CSF volume changes in the patients with AD were significantly associated with greater cognitive decline on the Mini-Mental State Examination. Furthermore, younger patients with AD showed more rapid progression on computed tomographic scans than did older patients.
The rate of CSF volume enlargement is region specific, with the most marked annual rate of change occurring in the ventricular system and the sylvian fissures. In addition, younger patients show more rapid progression in the ventricular and frontal sulcal brain regions of interest than do older patients.
本研究采用半自动图像分析技术，对健康成年人和阿尔茨海默病（AD）患者脑部计算机断层扫描检查中脑脊液（CSF）体积变化的速率和区域模式进行量化。
纵向、受试者内设计，并对纵向方法误差（如头部重新定位效应）进行统计校正。
加利福尼亚州帕洛阿尔托退伍军人事务医疗中心。
41例AD患者从老年精神病学研究室和帕洛阿尔托退伍军人事务医疗中心国家心理健康临床研究中心招募。35名健康对照受试者从当地社区招募。
根据计算机断层扫描估算脑脊液体积。
即使在考虑了计算机断层扫描检查中的方法误差估计值（如头部定位效应）后，AD患者的脑脊液年增加量仍高于对照组。这种脑脊液体积增大在感兴趣的脑区并不均匀；相反，AD患者在脑室系统和大脑外侧裂的体积增加不成比例。AD患者更大的脑脊液体积变化与简易精神状态检查中更严重的认知衰退显著相关。此外，较年轻的AD患者在计算机断层扫描上显示出比老年患者更快的进展。
脑脊液体积增大的速率具有区域特异性，年变化率最明显的是脑室系统和大脑外侧裂。此外，较年轻的患者在感兴趣的脑室和额叶脑沟区域的进展比老年患者更快。
