Temporoparietal MR imaging measures of atrophy in subjects with mild cognitive impairment that predict subsequent diagnosis of Alzheimer disease.
Temporoparietal MR imaging measures of atrophy in subjects with mild cognitive impairment that predict subsequent diagnosis of Alzheimer disease.
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DOI：
10.3174/ajnr.a1397
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发表时间：
2009-03
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影响因子：
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通讯作者：
Killiany RJ
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作者：
Desikan RS;Cabral HJ;Fischl B;Guttmann CR;Blacker D;Hyman BT;Albert MS;Killiany RJ
轻度认知障碍（MCI）是介于正常衰老和阿尔茨海默病（AD）之间的一种过渡状态。我们的目标是确定特定的颞顶区域是否可以预测从MCI进展到AD的时间。分析了129名MCI患者的MRI扫描，以确定14个新皮质和2个非新皮质脑区的体积，包括颞叶和顶叶。此外，还包括三个神经心理测试分数，以确定它们是否会提供独立的信息。平均随访5年后，其中44人进展为AD诊断。考克斯比例风险模型证明了六个MRI区域的显著影响，最大差异为：内嗅皮质（HR=0.54，p < 0.001）、顶下小叶（HR=0.64，p <0.005）和颞中回（HR=0.64，p < 0.004），表明体积越大风险越低。多变量模型显示，内嗅皮质（HR = 0.60，p < 0.001）和顶下小叶（HR = 0.62，p < 0.01）的组合是进展为AD的时间的“最佳”预测因子。多变量模型重申了在最终模型中纳入MRI和神经心理学变量的重要性。这些发现再次证实了内嗅皮层的重要性，并提供了顶下小叶作为从MCI进展到AD的时间预测因子的重要性的证据。在最终模型中纳入神经心理学表现继续强调以互补方式使用这些措施的重要性。
Mild cognitive impairment (MCI) represents a transitional state between normal aging and Alzheimer’s disease (AD). Our goal was to determine if specific temporoparietal regions can predict the time to progress from MCI to AD. MRI scans from 129 individuals with MCI were analyzed to identify the volume of 14 neocortical and 2 non-neocortical brain regions, comprising the temporal and parietal lobes. In addition, three neuropsychological test scores were included to determine whether they would provide independent information. After a mean follow-up time of 5 years, 44 of these individuals had progressed to a diagnosis of AD. Cox proportional hazards models demonstrated significant effects for six MRI regions with the greatest differences being: entorhinal cortex (HR=0.54, p < 0.001), inferior parietal lobule (HR=0.64, p <0.005), and middle temporal gyrus (HR=0.64, p < 0.004), indicating decreased risk with larger volumes. A multivariable model showed that a combination of the entorhinal cortex (HR = 0.60, p < 0.001) and inferior parietal lobule (HR = 0.62, p < 0.01) was the ‘best’ predictor of time to progress to AD. A multivariable model re-iterated the importance of included both MRI and neuropsychological variables in the final model. These findings reaffirm the importance of the entorhinal cortex and present evidence for the importance of the inferior parietal lobule as a predictor of time to progress from MCI to AD. The inclusion of neuropsychological performance in the final model continues to highlight the importance of using these measures in a complementary fashion.