Mapping the evolution of regional atrophy in Alzheimer's disease: Unbiased analysis of fluid-registered serial MRI
Mapping the evolution of regional atrophy in Alzheimer's disease: Unbiased analysis of fluid-registered serial MRI
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DOI：
10.1073/pnas.052587399
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发表时间：
2002-04-02
影响因子：
11.1
通讯作者：
Fox, NC
中科院分区：
文献类型：
--
作者：
Scahill, RI;Schott, JM;Fox, NC
阿尔茨海默病（AD）的特征在于进行性脑萎缩，其可以通过使用体积MRI来评估。我们描述了一种基于体素的非线性配准序列MRI分析，以证明在疾病的不同阶段最具统计学意义（P < 0.001）的变化区域。我们比较了早发和晚发AD患者的前驱症状（n = 4）、轻度（n = 10）和中度（n = 12），以及年龄和性别匹配的对照组，结果显示随着疾病的进展，全身萎缩增加。症状前和轻度受累患者海马萎缩率显著增加。随着疾病的进展，颞叶萎缩的分布发生了变化;当患者受到轻度或中度影响时，颞叶的下外侧区域显示出最显著的萎缩率增加。在所有的阶段，内侧顶叶萎缩的发生率都显著增加，额叶受累发生在疾病的后期。我们的研究结果表明，随着疾病的进展，显示最显着萎缩率的部位发生变化，并且在症状出现之前已经发生了区域萎缩。该技术提供了对AD自然史的深入了解，并且可能是评估疾病修饰治疗的疗效的有价值的工具，特别是如果这些治疗具有区域特异性效果。
Alzheimer's disease (AD) is characterized by progressive cerebral atrophy, which may be assessed by using volumetric MRI. We describe a voxel-based analysis of nonlinear-registered serial MRI to demonstrate the most statistically significant (P < 0.001) regions of change at different stages of the disease. We compared presymptomatic (n = 4), mild (n = 10), and moderately affected (n = 12) patients with early- and late-onset AD, with age- and sexmatched controls, and demonstrated increasing global atrophy with advancing disease. Significantly increased rates of hippocampal atrophy were seen in presymptomatic and mildly affected patients. There was a shift in the distribution of temporal lobe atrophy with advancing disease; the inferolateral regions of the temporal lobes showed the most significantly increased rates of atrophy by the time the patients were mildly or moderately affected. Significantly increased rates of medial parietal lobe atrophy were seen at all stages, with frontal lobe involvement occurring later in the disease. Our results suggest that the sites showing the most significant rates of atrophy alter as the disease advances, and that regional atrophy is already occurring before the onset of symptoms. This technique provides insights into the natural history of AD, and may be a valuable tool in assessing the efficacy of disease-modifying treatments, especially if these treatments were to have region-specific effects.