Atrophy of the putamen in dementia Lewy bodies but not Alzheimer's disease - An MRI study
Atrophy of the putamen in dementia Lewy bodies but not Alzheimer's disease - An MRI study
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DOI：
10.1212/01.wnl.0000091889.20347.30
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发表时间：
2003-11-11
期刊：
影响因子：
9.9
通讯作者：
O'Brien, JT
中科院分区：
文献类型：
--
作者：
Cousins, DA;Burton, EJ;O'Brien, JT
目的：比较阿尔茨海默病（AD）和路易体痴呆（DLB）受试者与年龄匹配的正常对照受试者的MRI壳核体积，沿着壳核体积与锥体外系体征和认知障碍严重程度之间的关系。研究方法：在AD（n=27; 77.6岁）和DLB（n=14; 76.2岁）老年患者和正常对照受试者（n=37; 75.4岁）中，在1.5 T条件下获得基于MRI的颅内总体积、脑总体积和壳核体积测量值。患者和对照受试者还接受了标准化的神经精神检查，包括统一帕金森病评定量表（剑桥认知检查（CAMCOG）和简易精神状态检查（MMSE）的运动部分。结果：DLB患者的原始壳核体积小于对照组（右侧减少12.5%，p=0.007;左侧减少13.7%，p=0.003）。当壳核体积归一化为颅内总体积时，DLB患者的体积比显著小于对照组和AD患者。AD患者的壳核体积与对照组无差异。在任何一组中，壳核体积与年龄或年龄相关性均不显著，也不与CAMCOG、MMSE评分相关。结论：壳核萎缩是DLB的一个特征。这可能是重要的，在了解帕金森病的特点，在DLB的病因，虽然在这项研究中，没有直接的相关性之间的体积损失程度和帕金森病的严重程度。
Objective: To compare the volume of the putamen on MRI in subjects with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) and age-matched normal control subjects, along with the relationship between putamen volume and severity of both extrapyramidal signs and cognitive impairment. Methods: MRI-based volumetric measurements at 1.5 T of total intracranial volume, total brain volume, and putamen volume were acquired in elderly patients with AD (n=27; 77.6 years) and DLB (n=14; 76.2 years) and normal control subjects (n=37; 75.4 years). Patients and control subjects also underwent a standardized neuropsychiatric examination including the motor subsection of the Unified Parkinson's Disease Rating Scale (UPDRS III) and the Cambridge Cognitive Examination (CAMCOG) with Mini-Mental State Examination (MMSE). Results: Patients with DLB had smaller raw putamen volumes than control subjects (right 12.5% reduction, p=0.007; left 13.7% reduction, p=0.003). When putamen volume was normalized to total intracranial volume, patients with DLB had significantly smaller volume ratios than both controls and patients with AD. Patients with AD did not differ from control subjects on any measure of putamen volume. Putamen volume did not correlate with age or with scores on UPDRS III, CAMCOG, or MMSE in any of the groups. Conclusions: Atrophy of the putamen is a feature of DLB. This may be important in understanding the etiology of parkinsonian features seen in DLB, though in this study, no direct correlation was found between degree of volume loss and severity of parkinsonism.