Mega M S, Thompson P M, Cummings J L, Back C L, Xu M L, Zohoori S, Goldkorn A, Moussai J, Fairbanks L, Small G W, Toga A W
Department of Neurology, Alzheimer's Disease Center, UCLA School of Medicine, Los Angeles, CA 90024-1769, USA.
Neurology. 1998 Jan;50(1):145-51. doi: 10.1212/wnl.50.1.145.
We mapped the three dimensional (3D) extents and variability of selected sulci in the Alzheimer's brain and explored the relationship between sulcal pattern and patient's cognitive performance. High-resolution MRIs of 10 patients with probable Alzheimer's disease (AD) were linearly transformed into a standard "normalized" 3D atlas (known as the Talairach coordinate system) and, on each relevant slice, contours of the left and right Sylvian fissure, anterior and posterior calcarine, callosal, parietooccipital, and cingulate sulci and the floor of the temporal horn of the lateral ventricle were traced. These landmarks were chosen because of their relative invariant location across individuals and because they demarcate functional boundaries relevant in AD. The sulcal contours were resolved into two-dimensional surfaces that cut through a brain volume. All 10 patients' sulcal surfaces were averaged to determine their mean spatial locations in the Talairach coordinate system. The 3D spatial extents of each patient's sulci were compared with their disease severity based on neuropsychological performance. The 3D sulcal variability, within the "normalized" atlas space, ranged from 4.0 mm for the left callosal sulcus to 9.1 mm for the left Sylvian fissure. Significant correlations were found among the spatial extents for the posterior floor of the right temporal horn of the lateral ventricle (r = -0.89, p < 0.001 for vertical extent) and right anterior calcarine sulcus (r = -0.75, p < 0.01 for anterior-posterior extent) with copying ability of the Rey-Osterrieth Complex Figure; the right anterior calcarine also had a significant relationship (r = -0.72, p = 0.02 for anterior-posterior extent) with performance on the Block Design subtest from the Wechsler Adult Intelligence Scale-Revised. Verbal fluency performance measured by the Controlled Oral Word Association Test was significantly related to the left cingulate (r = 0.91, p < 0.001 for anterior-posterior extent, and r = -0.82, p < 0.01 for vertical extent) and right cingulate (r = -0.72, p < or = 0.02 for vertical extent) sulci. This exploratory study is the first to evaluate the relationship between 3D sulcal variability and cognition; our preliminary findings suggest that the 3D pattern of sulci in the AD brain is related to the severity of the disease as reflected by cognitive performance. In the Talairach brain atlas, sulcal variability, within an AD population, approaches 1 cm. This large variability requires correction when functional imaging data are transformed into the Talairach atlas space to "normalize" individual morphologic differences.
我们绘制了阿尔茨海默病大脑中选定脑沟的三维（3D）范围和变异性，并探讨了脑沟模式与患者认知表现之间的关系。对10例可能患有阿尔茨海默病（AD）的患者的高分辨率磁共振成像进行线性变换，转换为标准的“归一化”3D图谱（即Talairach坐标系），并在每个相关切片上描绘左右外侧裂、前后距状沟、胼胝体沟、顶枕沟、扣带沟以及侧脑室颞角底部的轮廓。选择这些标志点是因为它们在个体间的位置相对不变，且它们划分了与AD相关的功能边界。脑沟轮廓被解析为贯穿脑体积的二维表面。将所有10例患者的脑沟表面进行平均，以确定它们在Talairach坐标系中的平均空间位置。根据神经心理学表现，将每位患者脑沟的3D空间范围与其疾病严重程度进行比较。在“归一化”图谱空间内，3D脑沟变异性范围从左侧胼胝体沟的4.0毫米到左侧外侧裂的9.1毫米。发现右侧侧脑室颞角后底部的空间范围（垂直范围r = -0.89，p < 0.001）和右侧前距状沟（前后范围r = -0.75，p < 0.01）与雷-奥斯特里思复杂图形临摹能力之间存在显著相关性；右侧前距状沟与韦氏成人智力量表修订版中的积木设计分测验表现也存在显著关系（前后范围r = -0.72，p = 0.02）。通过控制口语单词联想测验测量的言语流畅性表现与左侧扣带沟（前后范围r = 0.91，p < 0.001，垂直范围r = -0.82，p < 0.01）和右侧扣带沟（垂直范围r = -0.72，p ≤ 0.02）显著相关。这项探索性研究首次评估了3D脑沟变异性与认知之间的关系；我们的初步研究结果表明，AD大脑中脑沟的3D模式与认知表现所反映的疾病严重程度相关。在Talairach脑图谱中，AD人群内脑沟变异性接近1厘米。当将功能成像数据转换到Talairach图谱空间以“归一化”个体形态差异时，这种大的变异性需要进行校正。
