Convit A, De Leon M J, Tarshish C, De Santi S, Tsui W, Rusinek H, George A
Department of Psychiatry, New York University Medical Center, New York 10016, USA.
Neurobiol Aging. 1997 Mar-Apr;18(2):131-8. doi: 10.1016/s0197-4580(97)00001-8.
Our goal was to ascertain the involvement of the temporal lobe in the preclinical (not yet diagnosable) stages of dementia of the Alzheimer's type (DAT) by using MRI-derived volumes. We assessed anatomical subdivisions of the temporal lobe on three groups of carefully screened age- and education-matched elderly individuals: 27 normal elderly (NL), 22 individuals with minimal cognitive impairment (MCI), who did not fulfill DAT criteria but were regarded at high risk for future DAT, and 27 DAT individuals. We found hippocampal volume reductions of 14% for the MCI and 22% for the DAT group compared to the NL group. Utilizing regression analyses and after accounting for gender head size-age, generalized atrophy (CSF), and other temporal lobe subvolumes, the hippocampal volume separated NL from MCI individuals, correctly classifying 74%. For NL and MCI groups combined the hippocampal volume was the only temporal lobe subvolume related to delayed recall memory performance. When contrasting MCI and DAT individuals, the fusiform gyrus volume uniquely improved the ability of the hippocampal volume to separate MCI from DAT individuals from 74 to 80%. Our cross-sectional data suggest that, within the temporal lobe, specific hippocampal volume reductions separated the group at risk for DAT from the normal group. By the time impairments are sufficient to allow a diagnosis of DAT to be made, in addition to the medial temporal lobe volume reductions, the lateral temporal lobe is also showing volume reductions, most saliently involving the fusiform gyrus.
我们的目标是通过使用磁共振成像（MRI）得出的体积数据，确定颞叶在阿尔茨海默病型痴呆（DAT）临床前期（尚未可诊断）阶段的参与情况。我们在三组经过仔细筛选的年龄和教育程度匹配的老年人中评估了颞叶的解剖细分：27名正常老年人（NL）、22名轻度认知障碍（MCI）患者，他们不符合DAT标准，但被视为未来患DAT的高风险人群，以及27名DAT患者。我们发现，与NL组相比，MCI组的海马体体积减少了14%，DAT组减少了22%。利用回归分析，并在考虑了性别、头部大小、年龄、全身性萎缩（脑脊液）和其他颞叶子体积后，海马体体积将NL组与MCI个体区分开来，正确分类率为74%。对于NL组和MCI组合并而言，海马体体积是唯一与延迟回忆记忆表现相关的颞叶子体积。当对比MCI和DAT个体时，梭状回体积独特地将海马体体积区分MCI和DAT个体的能力从74%提高到了80%。我们的横断面数据表明，在颞叶内，特定的海马体体积减少将有患DAT风险的组与正常组区分开来。到足以做出DAT诊断的损伤出现时，除了内侧颞叶体积减少外，外侧颞叶也在显示体积减少，最明显的是涉及梭状回。
