Homocysteine and brain atrophy on MRI of non-demented elderly
Homocysteine and brain atrophy on MRI of non-demented elderly
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DOI：
10.1093/brain/awg006
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发表时间：
2003-01-01
期刊：
影响因子：
14.5
通讯作者：
Breteler, MMB
中科院分区：
文献类型：
--
作者：
den Heijer, T;Vermeer, SE;Breteler, MMB
阿尔茨海默病患者的血浆同型半胱氨酸水平高于对照组，但尚不确定较高的血浆同型半胱氨酸水平是否参与了疾病的早期发病机制。脑MRI上的海马、杏仁核和全脑萎缩被认为是阿尔茨海默病的早期标志。在鹿特丹扫描研究中，我们调查了1077名年龄在60-90岁之间的非痴呆患者的年龄相关脑变化的人群研究，研究了血浆同型半胱氨酸水平与MRI显示的海马、杏仁核和全脑萎缩严重程度之间的关系。我们使用轴向T-1加权MRI来可视化511名参与者的全球皮质脑萎缩（半定量测量;范围0-15）和3D HASTE（半傅立叶采集单次激发快速自旋回波）序列来测量海马和杏仁核体积。我们在1031名参与者和505名海马和杏仁核体积的参与者中测定了非空腹血浆同型半胱氨酸水平。血浆同型半胱氨酸水平较高的个体，平均而言，更多皮质萎缩[0.23单位（95% CI 0.07-0.38单位）/血浆同型半胱氨酸水平的标准差增加]和更多海马萎缩[左侧海马体积差异-0.05 ml（95% CI -0.09至-0.01）和右海马体积-0.03 ml（95% CI -0.07至0.01）/血浆同型半胱氨酸水平的标准差增加]。血浆同型半胱氨酸水平与杏仁核萎缩之间没有相关性。这些结果支持了这样的假设，即血浆同型半胱氨酸水平较高与老年人阿尔茨海默病风险中海马和皮质区域的萎缩有关。
Patients with Alzheimer's disease have higher plasma homocysteine levels than controls, but it is uncertain whether higher plasma homocysteine levels are involved in the early pathogenesis of the disease. Hippocampal, amygdalar and global brain atrophy on brain MRI have been proposed as early markers of Alzheimer's disease. In the Rotterdam Scan Study, a population-based study of age-related brain changes in 1077 non-demented people aged 60-90 years, we investigated the association between plasma homocysteine levels and severity of hippocampal, amygdalar and global brain atrophy on MRI. We used axial T-1-weighted MRIs to visualize global cortical brain atrophy (measured semi-quantitatively; range 0-15) and a 3D HASTE (half-Fourier acquisition single-shot turbo spin echo) sequence in 511 participants to measure hippocampal and amygdalar volumes. We had non-fasting plasma homocysteine levels in 1031 of the participants and in 505 of the participants with hippocampal and amygdalar volumes. Individuals with higher plasma homocysteine levels had, on average, more cortical atrophy [0.23 units (95% CI 0.07-0.38 units) per standard deviation increase in plasma homocysteine levels] and more hippocampal atrophy [difference in left hippocampal volume -0.05 ml (95% CI -0.09 to -0.01) and in right hippocampal volume -0.03 ml (95% CI -0.07 to 0.01) per standard deviation increase in plasma homocysteine levels]. No association was observed between plasma homocysteine levels and amygdalar atrophy. These results support the hypothesis that higher plasma homocysteine levels are associated with more atrophy of the hippocampus and cortical regions in elderly at risk of Alzheimer's disease.