MRI measures of entorhinal cortex vs hippocampus in preclinical AD
MRI measures of entorhinal cortex vs hippocampus in preclinical AD
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DOI：
10.1212/wnl.58.8.1188
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发表时间：
2002-04-23
期刊：
影响因子：
9.9
通讯作者：
Albert, MS
中科院分区：
文献类型：
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作者：
Killiany, RJ;Hyman, BT;Albert, MS
背景资料：内嗅皮层和海马的MRI测量已被用于预测哪些有记忆问题的非痴呆个体将在随访中达到AD的标准，但其相对准确性仍存在争议。目的：比较内嗅皮层和海马MRI测量值对预测AD的价值。研究方法：在137个个体中获得了内嗅皮层和海马的MRI体积，包括四组：1）在基线和3年随访后认知均正常的个体（n = 28），2）在基线和3年随访后均具有记忆困难但非痴呆的受试者（n = 73），3）在基线时具有记忆困难的受试者，其在随访的3年内被诊断为可能的AD（n = 21），和4）在基线时具有轻度AD的患者（n = 16）。结果如下：内嗅皮层和海马的测量值在两组之间的每一个成对比较中都是不同的（p < 0.001），并且与记忆测试相关（p < 0.01）。然而，内嗅皮层的体积将受试者与那些注定发展为痴呆症的人区分开来，具有相当的准确性（84%），而海马体的测量则没有。结论：这些发现与神经病理学数据一致，显示AD临床前阶段内嗅皮质大量受累，并表明随着疾病扩散，海马内发生萎缩性变化，这在MRI上是可测量的。
Background: MRI measures of the entorhinal cortex and the hippocampus have been used to predict which nondemented individuals with memory problems will progress to meet criteria for AD on follow-up, but their relative accuracy remains controversial. Objectives: To compare MRI measures of the entorhinal cortex and the hippocampus for predicting who will develop AD. Methods: MRI volumes of the entorhinal cortex and the hippocampus were obtained in 137 individuals comprising four groups: 1) individuals with normal cognition both at baseline and after 3 years of follow-up (n = 28), 2) subjects with memory difficulty but not dementia both at baseline and after 3 years of follow-up (n = 73), 3) subjects with memory difficulty at baseline who were diagnosed with probable AD within 3 years of follow-up (n = 21), and 4) patients with mild AD at baseline (n = 16). Results: Measures of both the entorhinal cortex and the hippocampus were different for each of the pairwise comparisons between the groups (p < 0.001) and were correlated with tests of memory (p < 0.01). However, the volume of the entorhinal cortex differentiated the subjects from those destined to develop dementia with considerable accuracy (84%), whereas the measure of the hippocampus did not. Conclusion: These findings are consistent with neuropathologic data showing substantial involvement of the entorhinal cortex in the preclinical phase of AD and suggest that, as the disease spreads, atrophic change develops within the hippocampus, which is measurable on MRI.