Patterns of Grey Matter Atrophy at Different Stages of Parkinson's and Alzheimer's Diseases and Relation to Cognition
Patterns of Grey Matter Atrophy at Different Stages of Parkinson's and Alzheimer's Diseases and Relation to Cognition
复制标题
DOI：
10.1007/s10548-018-0675-2
复制
发表时间：
2019-01-01
期刊：
影响因子：
2.7
通讯作者：
Rektorova, Irena
中科院分区：
文献类型：
--
作者：
Kunst, Jonas;Marecek, Radek;Rektorova, Irena
利用核磁共振成像，已经描述了阿尔茨海默病(AD)早期灰质(GM)萎缩的特征模式；帕金森病(PD)不同阶段的GM模式尚不确定。很少有研究直接比较由不同病理(AD、PD)引起的轻度认知障碍(MCI)组的结构变化。我们使用了几种分析方法来确定帕金森病和阿尔茨海默病不同阶段的GM变化。我们还评估了GM变化和认知测量之间的关联。共144例受试者，包括认知正常的帕金森病患者(PD-NC；n=23)、帕金森病合并MCI(PD-MCI；n=24)、遗忘型MCI(aMCI；n=27)、阿尔茨海默病(AD)(n=12)和年龄匹配的健康对照组(HC；n=58)。所有受试者均接受结构磁共振和认知检查。使用两种不同的技术分析GM体积：基于体素的形态计量学(VBM)和基于源的形态计量学(SBM)，这是一种多变量方法。此外，评估皮质厚度(CT)以评估组间GM的差异。认知领域的z分数与个体患者组中GM的变化相关。VBM测量的前扣带回和后扣带回的GM萎缩，SBM测量的颞额顶部分的GM萎缩，以及CT测量的后部皮质和前扣带回和额叶的GM萎缩，区分了aMCI和HC。主要的海马和颞叶萎缩(VBM，SBM)和一定程度的枕叶萎缩(SBM)是AD与aMCI和HC的区别。与认知缺陷的相关性只在AD组中存在。PD-MCI在眼眶额区(VBM)和左侧顶上小叶(CT)的GM萎缩程度较PD-NC大，这与记忆z评分有关；边缘和额顶枕叶新皮质萎缩(所有方法)均较PD-MCI更广泛，区别于HC。与HC相比，只有CT显示PD-NC的前扣带回、楔前叶和颞叶新皮质有轻微的GM萎缩。所有方法均未区分PD-MCI和aMCI。与HC相比，两个MCI组均表现出明显的边缘和额颞顶叶新皮质萎缩，组间无明显差异。AD受试者表现出典型的主要颞叶萎缩模式，这与所有认知领域的缺陷有关。与PD-NC相比，VBM和CT在识别PD-MCI的额叶和后部皮质萎缩方面比SBM更敏感。我们的数据支持这样的观点，即使用不同分析方法的研究结果不能直接进行比较。仅CT测量显示了HC和PD-NC之间的一些细微差别。
Using MRI, a characteristic pattern of grey matter (GM) atrophy has been described in the early stages of Alzheimer's disease (AD); GM patterns at different stages of Parkinson's disease (PD) have been inconclusive. Few studies have directly compared structural changes in groups with mild cognitive impairment (MCI) caused by different pathologies (AD, PD). We used several analytical methods to determine GM changes at different stages of both PD and AD. We also evaluated associations between GM changes and cognitive measurements. Altogether 144 subjects were evaluated: PD with normal cognition (PD-NC; n=23), PD with MCI (PD-MCI; n=24), amnestic MCI (aMCI; n=27), AD (n=12), and age-matched healthy controls (HC; n=58). All subjects underwent structural MRI and cognitive examination. GM volumes were analysed using two different techniques: voxel-based morphometry (VBM) and source-based morphometry (SBM), which is a multivariate method. In addition, cortical thickness (CT) was evaluated to assess between-group differences in GM. The cognitive domain z-scores were correlated with GM changes in individual patient groups. GM atrophy in the anterior and posterior cingulate, as measured by VBM, in the temporo-fronto-parietal component, as measured by SBM, and in the posterior cortical regions as well as in the anterior cingulate and frontal region, as measured by CT, differentiated aMCI from HC. Major hippocampal and temporal lobe atrophy (VBM, SBM) and to some extent occipital atrophy (SBM) differentiated AD from aMCI and from HC. Correlations with cognitive deficits were present only in the AD group. PD-MCI showed greater GM atrophy than PD-NC in the orbitofrontal regions (VBM), which was related to memory z-scores, and in the left superior parietal lobule (CT); more widespread limbic and fronto-parieto-occipital neocortical atrophy (all methods) differentiated this group from HC. Only CT revealed subtle GM atrophy in the anterior cingulate, precuneus, and temporal neocortex in PD-NC as compared to HC. None of the methods differentiated PD-MCI from aMCI. Both MCI groups showed distinct limbic and fronto-temporo-parietal neocortical atrophy compared to HC with no specific between-group differences. AD subjects displayed a typical pattern of major temporal lobe atrophy which was associated with deficits in all cognitive domains. VBM and CT were more sensitive than SBM in identifying frontal and posterior cortical atrophy in PD-MCI as compared to PD-NC. Our data support the notion that the results of studies using different analytical methods cannot be compared directly. Only CT measures revealed some subtle differences between HC and PD-NC.