Disconnection of the right superior parietal lobule from the precuneus is associated with memory impairment in oldest-old Alzheimer's disease patients.
Disconnection of the right superior parietal lobule from the precuneus is associated with memory impairment in oldest-old Alzheimer's disease patients.
复制标题
右顶上小叶与楔前叶的断开与老年阿尔茨海默病患者的记忆障碍有关。
DOI：
10.1016/j.heliyon.2020.e04516
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发表时间：
2020
期刊：
影响因子：
4
通讯作者：
Kira JI.
中科院分区：
文献类型：
--
作者：
Prawiroharjo P;Yamashita KI;Yamashita K;Togao O;Hiwatashi A;Yamasaki R;Kira JI.
阿尔茨海默病（Alzheimer's disease，AD）的发病年龄范围很广。新出现的证据表明，在最老的老年性AD（OOAD）的AD表现的变化，但是，认知功能障碍的模式仍然不清楚。本研究旨在通过静息态功能磁共振成像（rs-fMRI）研究来揭示OOAD患者的认知行为特征和脑功能连接的变化。我们招募了已转诊至九州大学医院（KUH）或山王医院的AD患者，并根据发病年龄将其分为中老年AD（MOAD）（65-79岁）和OOAD（≥80岁）。我们的研究对象包括19名OOAD，17名MOAD和8名正常人。认知能力采用简易精神状态检查-日本（MMSE-J）和临床痴呆评定（CDR）进行评价。对Sanno医院患者进行rs-fMRI扫描和独立成分分析（伊卡），并比较MOAD与OOAD患者。所得到的显著区域被用作KUH数据集的ROI到ROI分析的种子。总体而言，OOAD患者的MMSE-J延迟回忆子评分显著低于MOAD患者。Sanno医院数据的伊卡表明，与MOAD组相比，OOAD组右侧上级顶叶（SPL）的默认模式网络（DMN）的连通性显著降低。KUH数据集的ROI到ROI分析表明，OOAD组的右侧SPL与楔前叶显著断开（p < 0.01）。从右SPL到楔前叶的功能连接与MMSE-J延迟回忆子评分呈正相关（p = 0.03），与CDR记忆子量表呈负相关（p = 0.04）。这些结果表明，右SPL和楔前叶之间的断开可能会导致更差的记忆能力在OOAD相比，MOAD。
There is a wide range of onset age in Alzheimer's disease (AD). Emerging evidence indicates variation of AD manifestations in oldest-old AD (OOAD); however, the pattern of cognitive dysfunctions remains unclear. We aimed to reveal cognitive performance characteristics and changes in brain functional connectivity in OOAD patients by a resting-state fMRI (rs-fMRI) study. We enrolled AD patients who had been referred to Kyushu University Hospital (KUH) or Sanno Hospital, and classified them into middle-old AD (MOAD) (65–79 years old) and OOAD (≥80 years old) according to the age of onset. Our subjects consisted of 19 OOAD, 17 MOAD, and 8 normal subjects. Cognitive performance was evaluated using Mini Mental State Examination-Japanese (MMSE-J) and Clinical Dementia Rating (CDR). rs-fMRI scanning and independent component analysis (ICA) were performed on Sanno Hospital patients and MOAD vs. OOAD patients were compared. The resulting significant regions were used as seeds for ROI-to-ROI analysis of the KUH dataset. Collectively, MMSE-J delayed recall sub-scores were significantly lower in OOAD patients compared with MOAD patients. ICA of the Sanno Hospital data indicated significant connectivity decrease in the default mode network (DMN) in the OOAD group compared with the MOAD group in the right superior parietal lobule (SPL). ROI-to-ROI analysis of the KUH dataset indicated significant disconnection in the OOAD group of the right SPL from the precuneus (p < 0.01). The functional connectivity from the right SPL to the precuneus was positively correlated with the MMSE-J delayed recall sub-score (p = 0.03) and negatively correlated with the CDR memory sub-scale (p = 0.04). These findings indicate that disconnection between the right SPL and the precuneus may contribute to worse memory capability in OOAD compared with MOAD.