Decreased white matter integrity before the onset of delusions in patients with Alzheimer's disease: diffusion tensor imaging.
Decreased white matter integrity before the onset of delusions in patients with Alzheimer's disease: diffusion tensor imaging.
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DOI：
10.2147/ndt.s38942
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发表时间：
2013
影响因子：
3.2
通讯作者：
Mimura M
中科院分区：
文献类型：
--
作者：
Nakaaki S;Sato J;Torii K;Oka M;Negi A;Nakamae T;Narumoto J;Miyata J;Furukawa TA;Mimura M
阿尔茨海默病(AD)患者与脑白质(WM)异常相关的妄想的病理机制还知之甚少。此外，作为妄想症基础的WM完整性异常是否在妄想症发生之前就已经形成，目前尚不清楚。在这项研究中，我们使用扩散张量成像方法来检查患有妄想症的AD患者和没有出现妄想症的AD患者的WM完整性基线异常的存在。使用神经精神病学调查表，我们确定了在一年内表现出妄想症的AD患者。所有患者在基线时都接受了磁共振成像(MRI)检查。我们使用基于轨迹的空间统计软件进行分数各向异性，并将出现妄想症的AD患者和没有出现妄想症的AD患者的结果进行比较。与未出现妄想症的AD患者(n=15)相比，出现妄想症的AD患者(n=10)表现出两个相对较大的簇和一个较小的簇，其分数各向异性结果明显较低。第一束位于左侧顶枕区，由左侧下纵束、额枕下束、后冠放射状、胼胝体大钳等纤维组成。第二个簇位于胼胝体主体上。第三个最小的簇位于颞叶上回白质。涉及多个纤维的WM完整性异常可能是AD患者妄想发生的关键。
The pathology of delusions in patients with Alzheimer’s disease (AD) associated with white matter (WM) abnormalities is poorly understood. In addition, whether the abnormalities in WM integrity that underlie the delusions develop before the onset of the delusions remains unclear. In this study, we used a diffusion tensor imaging approach to examine the existence of baseline abnormalities in WM integrity in AD patients who developed delusions and AD patients who did not develop delusions. Using the Neuropsychiatric Inventory, we identified patients with AD who exhibit delusions during a 1-year period. All the patients underwent a magnetic resonance imaging (MRI) examination at baseline. We conducted fractional anisotropy using tract-based spatial statistics software and compared the results of AD patients who developed delusions with those who did not develop delusions. Compared with the AD patients who did not develop delusions (n = 15), the AD patients who developed delusions (n = 10) exhibited two relatively large clusters and one minimal cluster of significantly lower fractional anisotropy results. The first cluster was located in the left parieto-occipital region and included several fibers: the left inferior longitudinal fasciculus, the inferior fronto-occipital fasciculus, the posterior corona radiate, and the forceps major of the corpus callosum. The second cluster was located on the body of the corpus callosum. A third minimal cluster was located on the superior temporal gyrus white matter. Abnormalities in WM integrity involving several fibers may be crucial to the development of delusions in AD patients.