Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment
Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment
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DOI：
10.1212/wnl.52.7.1397
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发表时间：
1999-04-22
期刊：
影响因子：
9.9
通讯作者：
Kokmen, E
中科院分区：
文献类型：
--
作者：
Jack, CR;Petersen, RC;Kokmen, E
目的：验证基于MRI的海马体积测量与轻度认知功能障碍（MCI）老年患者未来转化为阿尔茨海默病（AD）的风险相关的假设。背景：AD患者会经历一个过渡状态，这可以被描述为MCI。然而，在一些患者中，MCI是一种更良性的疾病，可能不会进展为AD或进展缓慢。患者：从马约诊所阿尔茨海默病中心/阿尔茨海默病患者登记处招募了80名符合MCI诊断标准的连续患者。方法：在进入研究时，每个患者都接受了头部MRI检查，从中测量了两个脑丘的体积。对患者进行纵向随访，大约每年进行一次临床/认知评估。主要终点是在纵向临床随访期间，个别MCI患者与AD临床诊断的交叉。结果：在平均32.6个月的纵向观察期间，80例MCI患者中有27例发生痴呆。基线时的海马萎缩与从MCI到AD的交叉相关（相对风险[RR]，0.69，p = 0.015）。当海马体积进入双变量模型时，使用年龄，绝经后雌激素替代，标准神经心理学测试，载脂蛋白E（APOE）基因型，缺血性心脏病史和高血压，RR与单变量模型没有实质性差异，海马体积和交叉之间的关联仍然显着。结论：在老年MCI患者中，通过病前MRI体积测量确定的海马萎缩可预测随后向AD的转化。
Objective: To test the hypothesis that MRI-based measurements of hippocampal volume are related to the risk of future conversion to Alzheimer's disease (AD) in older patients with a mild cognitive impairment (MCI). Background: Patients who develop AD pass through a transitional state, which can be characterized as MCI. In some patients, however, MCI is a more benign condition, which may not progress to AD or may do so slowly. Patients: Eighty consecutive patients who met criteria for the diagnosis of MCI were recruited from the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry. Methods: At entry into the study, each patient received an MRI examination of the head, from which the volumes of both hippocampi were measured. Patients were followed longitudinally with approximately annual clinical/cognitive assessments. The primary endpoint was the crossover of individual MCI patients to the clinical diagnosis of AD during longitudinal clinical follow-up. Results: During the period of longitudinal observation, which averaged 32.6 months, 27 of the 80 MCI patients became demented. Hippocampal atrophy at baseline was associated with crossover from MCI to AD (relative risk [RR], 0.69, p = 0.015). When hippocampal volume was entered into bivariate models-using age, postmenopausal estrogen replacement, standard neuropsychological tests, apolipoprotein E (APOE) genotype, history of ischemic heart disease, and hypertension-the RRs were not substantially different from that found univariately, and the associations between hippocampal volume and crossover remained significant. Conclusion: In older patients with MCI, hippocampal atrophy determined by premorbid MRI-based volume measurements is predictive of subsequent conversion to AD.