Diffusion tensor imaging of the brain in patients with Alzheimer's disease and cerebrovascular lesions
Diffusion tensor imaging of the brain in patients with Alzheimer's disease and cerebrovascular lesions
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DOI：
10.1631/jzus.2007.b0242
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发表时间：
2007-04-01
影响因子：
5.1
通讯作者：
Zou Yan
中科院分区：
文献类型：
--
作者：
Chen Shao-qiong;Kang Zhuang;Zou Yan
背景：近年来的尸检研究表明阿尔茨海默病（AD）患者脑血管病变的发生率较高。为了评估脑血管病变对AD的影响，我们使用扩散张量成像（DTI）研究了有和无脑血管病变的AD患者。材料与方法：对10例疑似AD患者、10例AD/V患者（疑似AD伴脑血管病变）和10例正常对照者进行常规和DTI扫描。测量了与AD病理相关的一些结构的平均扩散率（D）和各向异性分数（FA）值。结果：AD患者海马和扣带回的D值高于对照组。在AD/V患者中，与对照组相比，在相同的结构中以及在丘脑和基底节中发现D值增加。AD和AD/V患者的D值有显著性差异。AD/V患者左侧颞下回白色物质和双侧扣带回中部FA值较对照组降低。MMSE评分与右侧海马（r=0.639，P < 0.019）、右侧扣带回前部（r=0.587，P < 0.035）和左侧海马旁回（r=0.559，P < 0.047）FA值呈显著相关。结论：脑血管病变对D值的影响比单纯AD病变更大。AD/V患者丘脑和基底节D值升高可能与认知功能下降有关。AD/V患者的FA值降低可能表明脑血管病变比单纯AD病变诱导更严重的白色损害。
Background: Recent autopsy study showed a high incidence of cerebrovascular lesions in Alzheimer's disease (AD). To assess the impact of cerebrovascular pathology in AD, we used diffusion tensor imaging (DTI) to study AD patients with and without cerebrovascular lesions. Materials and Methods: Conventional and DTI scans were obtained from 10 patients with probable AD, 10 AD/V patients (probable AD with cerebrovascular lesions) and ten normal controls. Mean diffusivity (D) and fractional anisotropy (FA) values of some structures involved with AD pathology were measured. Results: D value was higher in AD patients than in controls in hippocampus and the cingulate gyrus. In AD/V patients, increased D value was found in the same structures and also in the thalamus and basal ganglia compared to controls. There was a significant difference of D value between AD and AD/V patients. FA value reduced in the white matter of left inferior temporal gyrus and in the bilateral middle cingulate gyrus in patients with AD/V compared with controls. The MMSE (mini-mental state examination) score significantly correlated with FA value in the right hippocampus (r=0.639, P < 0.019), in the right anterior cingulate gyrus (r=0.587, P < 0.035) and in left parahippocampal gyrus (r=0.559, P < 0.047). Conclusion: Cerebrovascular pathology had stronger impact on the D value than the AD pathology alone did. Elevated D value in thalamic and basal ganglia may contribute to cognitive decline in AD/V patients. Reduced FA values in AD/V patients may indicate that cerebrovascular pathology induced more severe white matter damage than the AD pathology alone did.