Rates of hippocampal atrophy correlate with change in clinical status in aging and AD
Rates of hippocampal atrophy correlate with change in clinical status in aging and AD
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DOI：
10.1212/wnl.55.4.484
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发表时间：
2000-08-22
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
背景资料：老年人群中的认知连续体可以在概念上分为功能正常的人群（对照受试者）、轻度认知障碍（MCI）人群和可能患有AD的人群。目的：检验海马萎缩的年发生率作为基线和临床组成员关系（对照、MCI或AD）变化的函数而不同的假设。研究方法：作者从马约诊所AD研究中心/AD患者登记处确定了129例受试者，这些受试者在入组时和3 +/- 1年后的后续临床随访评价时均符合正常对照受试者、MCI或可能AD的既定标准。每例受试者在初始评估和随访临床评估时接受头部MRI检查;计算海马体积的年百分比变化。在基线时被归类为对照组或MCI患者的受试者在观察期间可以保持认知稳定或下降至较低功能组。结果如下：三个初始临床组中的每一个的海马体积损失的年化速率按以下顺序进行性降低：AD > MC >对照。在对照组和MCI组中，那些下降的人比那些保持临床稳定的人有更大的体积损失率。按随访临床组划分的海马萎缩的平均年发生率为：对照稳定1.73%，对照下降2.81%，MCI稳定2.55%，MCI下降3.69%，AD 3.5%。结论：海马萎缩的发生率与基线认知状态和处于沿着从正常到MCI再到AD的认知连续体的老年人的认知状态随时间的变化相匹配。
Background: The cognitive continuum in the elderly population can be conceptually divided into those who are functioning normally (control subjects), those with a mild cognitive impairment (MCI), and those with probable AD. Objectives: To test the hypothesis that the annualized rates of hippocampal atrophy differ as a function of both baseline and change in clinical group membership (control, MCI, or AD). Methods: The authors identified 129 subjects from the Mayo Clinic AD Research Center/AD Patient Registry who met established criteria for normal control subjects, MCI, or Probable AD, both at entry and at the time of a subsequent clinical follow-up evaluation 3 +/- 1 years later. Each subject underwent an MRI examination of the head at the time of the initial assessment and at follow-up clinical assessment; the annualized percentage change in hippocampal volume was computed. Subjects who were classified as controls or patients with MCI at baseline could either remain cognitively stable or could decline to a lower functioning group over the period of observation. Results: The annualized rates of hippocampal volume loss for each of the three initial clinical groups decreased progressively in the following order: AD > MC > control. Within the control and MCI groups, those who declined had a significantly greater rate of volume loss than those who remained clinically stable. The mean annualized rates of hippocampal atrophy by follow-up clinical group were: control-stable 1.73%, control-decliner 2.81%, MCI-stable 2.55%, MCI-decliner 3.69%, AD 3.5%. Conclusion: Rates of hippocampal atrophy match both baseline cognitive status and the change in cognitive status over time in elderly persons who lie along the cognitive continuum from normal to MCI to AD.