Correlation between cerebral blood flow and olfactory function in mild cognitive impairment and Alzheimer's disease
Correlation between cerebral blood flow and olfactory function in mild cognitive impairment and Alzheimer's disease
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DOI：
10.1002/gps.5527
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发表时间：
2021-03-10
影响因子：
4
通讯作者：
Kazui, Hiroaki
中科院分区：
文献类型：
--
作者：
Kashibayashi, Tetsuo;Takahashi, Ryuichi;Kazui, Hiroaki
目的嗅觉功能障碍在轻度认知障碍（MCI）或阿尔茨海默病（AD）患者中很常见。我们试图通过使用123I-IMP-SPECT检测区域脑血流量（CBF）来阐明MCI和早期AD患者与嗅觉功能障碍相关的脑区域。方法：我们纳入了218例被诊断为AD或MCI的患者，他们接受了全面的神经精神病学和神经心理学测试、阿尔茨海默病评估量表-认知部分（ADAS-Cog）和前后手指跨度。采用T&T法对5种气味进行嗅觉功能评估；患者陈述他们是否感受到任何气味（检测测试）并识别气味（识别测试）。将性别、年龄和教育程度作为协变量参数，通过逐体元的多元回归分析，研究了基于单光子发射计算机断层扫描的区域CBF与嗅觉功能之间的关系。结果218例患者中嗅觉轻度受损78例，嗅觉丧失15例；此外，213人有轻度嗅觉识别障碍。气味检测得分与ADAS-Cog单词回忆得分显著相关（r = 0.193, p = 0.004）。气味识别分数与ADAS记忆分数（r = 0.408, p < 0.001）和ADAS取向分数（r = 0.292, p < 0.001）显著相关。气味识别评分与左颞极、内嗅区和双侧额极CBF呈负相关（p < 0.001）。结论MCI合并AD患者嗅觉识别功能障碍与左颞极、内嗅区和双侧额极脑血流减少有关。
Objective Olfactory dysfunction is common in patients with mild cognitive impairment (MCI) or Alzheimer's disease (AD). We sought to elucidate brain regions associated with olfactory dysfunction in patients with MCI and early AD by using 123I-IMP-SPECT to detect regional cerebral blood flow (CBF).Methods We included 218 patients diagnosed with AD or MCI, who underwent a comprehensive battery of neuropsychiatric and neuropsychological tests, Alzheimer's Disease Assessment Scale-Cognitive Part (ADAS-Cog), and forward- and backward-digit span. Olfactory function was assessed using T&T olfactometry of five odors; patients stated whether they experienced any smell (detection test) and identified the odor (identification test). The association between single-photon emission computerized tomography based regional CBF and olfactory function was examined by voxel-by-voxel multiple regression analysis, considering sex, age, and education as covariate parameters.Results Of the 218 patients, 78 had mildly impaired olfactory detection and 15 had olfactory detection loss; additionally, 213 had mild olfactory identification impairment. The odor detection score correlated significantly with the ADAS-Cog word recall score (r = 0.193, p = 0.004). The odor identification score correlated significantly with the ADAS memory (r = 0.408, p < 0.001) and ADAS orientation (r = 0.292, p < 0.001) scores. The odor identification score correlated negatively with CBF in the left temporal pole, entorhinal area, and bilateral frontal poles (p < 0.001).Conclusion Olfactory identification dysfunction in patients with MCI and AD is attributable to reduced CBF of the left temporal pole, entorhinal area, and bilateral frontal pole.