Krasuski J S, Alexander G E, Horwitz B, Daly E M, Murphy D G, Rapoport S I, Schapiro M B
Laboratory of Neurosciences, National Institute on Aging, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
Biol Psychiatry. 1998 Jan 1;43(1):60-8. doi: 10.1016/s0006-3223(97)00013-9.
The clinical diagnosis of Alzheimer's disease (AD) can be difficult to make in early stages of disease. Structural neuroimaging offers a potential tool in the clinical diagnosis of AD with mild cognitive impairment. Postmortem studies indicate that early neuropathology in AD occurs in medial temporal lobe limbic structures. Magnetic resonance imaging (MRI) studies that assessed these volumes in mildly impaired AD patients remain inconclusive.
Using MRI, we measured volumes of left and right hippocampus, amygdala, and anterior and posterior parahippocampal gyrus (PHG) in 13 AD patients with mild cognitive impairment, defined as > or = 20 on the Mini-Mental State Exam, and in 21 healthy age- and sex-matched controls.
The AD patients had smaller medial temporal lobe volumes, except for the right anterior PHG. Discriminant function analysis using MRI volumes produced 94% correct group classification.
These results show that in mildly impaired AD patients atrophy is present in medial temporal lobe structures; that MRI volumes of the anterior PHG, which contains entorhinal cortex, are reduced, but the amygdala and hippocampal volumes show greater reduction; and that discriminant function analysis using all volumes as predictors can correctly classify a high proportion of individuals.
阿尔茨海默病(AD)的临床诊断在疾病早期可能较为困难。结构神经影像学为伴有轻度认知障碍的AD临床诊断提供了一种潜在工具。尸检研究表明,AD早期神经病理学改变发生在内侧颞叶边缘结构。对轻度受损AD患者这些脑区体积进行评估的磁共振成像(MRI)研究结果尚无定论。
我们使用MRI测量了13例轻度认知障碍AD患者(定义为简易精神状态检查表得分≥20分)以及21名年龄和性别匹配的健康对照者的左右海马体、杏仁核以及海马旁回(PHG)前后部的体积。
AD患者内侧颞叶体积较小,但右侧前海马旁回除外。利用MRI体积进行判别函数分析,正确分组率达94%。
这些结果表明,轻度受损AD患者的内侧颞叶结构存在萎缩;包含内嗅皮质的前海马旁回MRI体积减小,但杏仁核和海马体体积减小更为明显;并且以所有体积作为预测指标进行判别函数分析能够正确分类大部分个体。