Differential cortical atrophy in subgroups of mild cognitive impairment
Differential cortical atrophy in subgroups of mild cognitive impairment
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DOI：
10.1001/archneur.62.9.1393
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发表时间：
2005-09-01
影响因子：
--
通讯作者：
Becker, JT
中科院分区：
文献类型：
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作者：
Bell-McGinty, S;Lopez, OL;Becker, JT
目的：比较诊断为轻度认知障碍（MCI）亚型的患者的灰质脑体积设计：MCI亚组的磁共振成像容积研究（MCI-遗忘[MCI-A]和MCI-多认知域[MCI-MCD]）使用基于全脑体素的分析。37例MCI患者（年龄范围，49-85岁; MCI-A，n=9; MCI-MCD，n=28）和47例对照受试者（年龄范围，55-81岁）。主要结果测量：MCI亚组和正常对照组之间以及进展为痴呆的MCI患者之间的体积解剖磁共振成像差异。结果：MCI组双侧海马和颞中回体积均较对照组明显减小，差异有统计学意义（P < 0. 05）。与MCI-MCD组相比，MCI-A组左内嗅皮质和顶叶下叶体积明显减少。与MCI-A患者相比，MCI-MCD患者的右侧额下回、右侧颞中回和双侧上级颞回体积显著减小。MCI患者在随访期间（平均间隔2年，最长4.5年）进展到阿尔茨海默病，表现出更大的萎缩，在左侧内嗅皮层，双侧上级颞回，和右额下回相比，与那些谁没有progress.Conclusions：这些数据提供了证据，在2组MCI患者明显的脑结构异常。虽然两者都有内侧颞叶和皮质体积损失，但与弥漫性认知功能障碍的MCI患者相比，具有局灶性记忆缺陷的患者更多地参与内侧颞叶结构，而较少参与新皮质异模态关联区。因此，MCI可能代表了一个比目前设想的更异质的群体，可能反映了痴呆的2种不同病因学过程。这些数据还表明，这些结构异常先于阿尔茨海默病的发展。
Objective: To compare gray matter brain volumes in patients diagnosed with subtypes of mild cognitive impairment (MCI) (those with a focal amnestic disorder and those with more diffuse cognitive dysfunction) with those of elderly controls.Design: Magnetic resonance imaging volumetric study of MCI subgroups (MCI-amnestic [MCI-A], and MCI-multiple cognitive domain [MCI-MCD]) using a whole brain voxel-based analysis.Setting: Referral dementia clinic.Patients: Thirty-seven patients with MCI (age range, 49-85 years; MCI-A, n=9; MCI-MCD, n=28) and 47 control subjects (age range, 55-81 years).Main Outcome Measures: Volumetric anatomical magnetic resonance imaging differences between MCI subgroups and normal controls, and between patients with MCI who progressed to dementia. Magnetic resonance imaging scans were analyzed using statistical software SPM99.Results: Overall, the patients with MCI had significantly decreased volume in the hippocampus and middle temporal gyrus, bilaterally, compared with control subjects. Compared with patients with MCI-MCD, patients with MCI-A had significant volume loss of the left entorhinal cortex and inferior parietal lobe. Compared with patients with MCI-A, patients with MCI-MCD had significantly reduced volume of the right inferior frontal gyrus, right middle temporal gyrus, and bilateral superior temporal gyrus. Patients with MCI who progressed to Alzheimer disease during follow-up (mean interval 2 years, maximum 4.5 years), showed greater atrophy in the left entorhinal cortex, bilateral superior temporal gyri, and right inferior frontal gyrus compared with those who did not progress.Conclusions: These data provide evidence of distinct brain structural abnormalities in 2 groups of patients with MCI. While both have mesial temporal and cortical volume loss, those with a focal memory deficit have more involvement of the mesial temporal structures and less involvement of the neocortical heteromodal association areas than those patients with MCI with diffuse cognitive dysfunction. Thus, MCI may represent a more heterogeneous group than currently conceived, possibly reflecting 2 different etiological processes to dementia. These data also suggest that these structural abnormalities precede the development of Alzheimer disease.