Differences in Microstructural Alterations of the Hippocampus in Alzheimer Disease and Idiopathic Normal Pressure Hydrocephalus: A Diffusion Tensor Imaging Study
Differences in Microstructural Alterations of the Hippocampus in Alzheimer Disease and Idiopathic Normal Pressure Hydrocephalus: A Diffusion Tensor Imaging Study
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DOI：
10.3174/ajnr.a2207
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发表时间：
2010-11-01
影响因子：
3.5
通讯作者：
Yang, D. W.
中科院分区：
文献类型：
--
作者：
Hong, Y. J.;Yoon, B.;Yang, D. W.
背景与目的：DTI可以通过测量FA和MD来评估WM束的降解。许多研究已经报道了AD海马FA/ MD值的降低。相比之下，只有少数研究报道了使用DTI技术治疗脑积水。在老年痴呆和心室扩张患者中，通常很难通过MR成像的视觉测量来区分iNPH和AD。本研究的目的是通过DTI研究iNPH海马微结构完整性的变化，并确定该方法是否可以作为区分iNPH与AD的新诊断工具。材料和方法：我们招募了43名参与者（15名健康对照，15名AD患者和13名iNPH患者）。采用感兴趣区法测定两侧海马头、体、尾的FA和MD值。包括临床病史、神经系统检查和神经心理评估。结果：AD患者FA值最低，iNPH患者FA值最低，健康对照最低。MD值依次最高。这些结果在双侧海马区域的3个细分中是一致的。iNPH和AD患者的海马体积没有差异。结论：AD和iNPH对海马的微结构改变比体积变化更敏感。DTI分析可能是区分AD和iNPH的有效工具。
BACKGROUND AND PURPOSE: DTI can be used to assess the degradation of WM tracts by measuring the FA and MD. Decreased FA/increased MD values in the AD hippocampus have been reported by many studies. In contrast, only a few studies reported on hydrocephalus by using the DTI technique. In elderly patients with dementia and with dilated ventricles, it is often difficult to differentiate iNPH from AD with visual measurements on MR imaging. The aim of this study was to investigate the changes of microstructural integrity of the hippocampus in iNPH by using DTI and determining whether this method could be a new diagnostic tool to differentiate iNPH from AD.MATERIALS AND METHODS: We recruited 43 participants (15 healthy controls, 15 patients with AD, and 13 patients with iNPH). The FA and MD values were measured by using the region-of-interest method in the hippocampal head, body, and tail on both sides. Clinical history, neurologic examination, and neuropsychological assessment were included.RESULTS: The FA values were the lowest in the patients with AD, the patients with iNPH, and the healthy controls in this order. The MD values were the highest in the same order. These findings were consistent in the 3 subdivisions of the bilateral hippocampal regions. Hippocampal volume was not different between patients with iNPH and AD.CONCLUSIONS: The microstructural alterations of the hippocampus were more sensitive than the volumetric changes in AD and iNPH. DTI analysis might be a useful tool for discriminating AD from iNPH.