Longitudinal evaluation of both morphologic and functional changes in the same individuals with Alzheimer's disease.
Longitudinal evaluation of both morphologic and functional changes in the same individuals with Alzheimer's disease.
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发表时间：
2002-03
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通讯作者：
H. Matsuda;N. Kitayama;T. Ohnishi;T. Asada;S. Nakano;Shigeki Sakamoto;E. Imabayashi;Asako Katoh
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作者：
H. Matsuda;N. Kitayama;T. Ohnishi;T. Asada;S. Nakano;Shigeki Sakamoto;E. Imabayashi;Asako Katoh
形态学和功能成像研究并不总是对阿尔茨海默病（AD）中显示萎缩性改变和血流或代谢减少的脑区给出一致的结果。本研究的目的是确定初始异常和纵向变化的形态和功能测量为同一个人与AD。方法对15例轻度AD患者和25名年龄匹配的健康志愿者进行调查。AD患者接受MRI和SPECT检查3次，间隔约1年。使用统计参数映射（这是立体定向空间中基于体素的分析）将AD患者的MRI分割的灰质体积和SPECT测量的局部脑血流量（rCBF）与健康志愿者进行比较。结果脑局部萎缩区与脑血流量下降区之间存在明显的不一致性。内侧颞区灰质体积的减少比rCBF更快、更广泛。与基线研究时的值相比，扣带回后部和楔前叶以及联合顶叶皮质的rCBF广泛降低。与此相反，即使在随访研究中，灰质体积在该区域的显著降低程度仍然比rCBF窄得多。额叶区，包括前扣带回和眶额区，表现出进行性减少的rCBF和灰质体积。与灰质体积的减少相比，rCBF的减少发生在颞叶联合皮质的后部。结论在AD的纵向研究中，形态学和功能变化之间存在明显的不一致性。功能变化可能部分是由来自形态学上涉及的连接性降低的区域的远程效应引起的，部分是由神经元可塑性的代偿反应引起的。
UNLABELLED Morphologic and functional imaging studies have not always given concordant results about brain areas showing atrophic changes and reduced flow or metabolism in Alzheimer's disease (AD). The aim of this study was to determine the initial abnormality and the longitudinal changes in both morphologic and functional measurements for the same individuals with AD. METHODS We investigated 15 patients with mild AD and 25 age-matched healthy volunteers. The AD patients underwent both MRI and SPECT 3 times at intervals of approximately 1 y. The gray matter volume, as segmented from MRI, and the regional cerebral blood flow (rCBF), as measured by SPECT, of AD patients were compared with those of healthy volunteers using statistical parametric mapping, which is a voxel-based analysis in stereotactic space. RESULTS Considerable discordance between areas of regional atrophy and areas of decreased rCBF was observed. The medial temporal areas showed a faster and more extensive reduction of gray matter volume than of rCBF. In comparison with the value at the baseline study, rCBF in the posterior cingulate gyrus and precuneus and the associative parietal cortex was extensively decreased. In contrast, the extent of significant decrease in this area continued to be much narrower for gray matter volume than for rCBF, even in the follow-up studies. Frontal areas, including the anterior cingulate gyrus and the orbitofrontal areas, showed a progressive reduction in both rCBF and gray matter volume. The reduction in rCBF was in a more posterior part of the associative temporal cortex than was the reduction in gray matter volume. CONCLUSION These results indicate a distinct discordance between morphologic and functional changes in a longitudinal study of AD. Functional changes may be caused partly by remote effects from the morphologically involved areas with decreased connectivity and partly by a compensatory response by neuronal plasticity.