Correlating Cognitive Decline with White Matter Lesion and Brain Atrophy Magnetic Resonance Imaging Measurements in Alzheimer's Disease.
Correlating Cognitive Decline with White Matter Lesion and Brain Atrophy Magnetic Resonance Imaging Measurements in Alzheimer's Disease.
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DOI：
10.3233/jad-150400
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Davatzikos C
中科院分区：
文献类型：
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作者：
Bilello M;Doshi J;Nabavizadeh SA;Toledo JB;Erus G;Xie SX;Trojanowski JQ;Han X;Davatzikos C
血管危险因素日益被认为是阿尔茨海默病(AD)和轻度认知障碍(MCI)早期转化为痴呆的危险因素。虽然阿尔茨海默病的神经影像研究主要集中在脑萎缩、代谢功能或淀粉样蛋白沉积等方面，但对脑血管疾病对认知功能下降的影响关注较少。研究AD、MCI和对照组受试者脑萎缩和脑白质损害与认知功能减退的相关性。研究对象包括阿尔茨海默病和MCI患者以及健康受试者。受试者接受基线MRI扫描，并进行基线和随访神经心理成套检查(CERAD)。测量区域体积，并进行脑白质病变分割。评价CERAD减分率与脑白质损伤负荷及脑结构体积的相关性。此外，还计算了基于体素的基线CERAD评分与萎缩和白质病变测量之间的相关性。CERAD的下降率与穹隆部位的病变负荷关系最为显著。几个颞叶ROI体积与CERAD下降显著相关。基于体素的分析表明，基线CERAD评分与前颞叶萎缩程度之间存在很强的相关性。在多叶皮质下白质中，基线CERAD评分与白质病变体积的相关性达到显著水平。CERAD评分的基线和下降均与脑白质损伤负荷和灰质萎缩相关。这项研究的结果强调了容量损失的主要影响，并强调了小血管疾病作为老年人认知能力下降的贡献者的重要性。
Vascular risk factors are increasingly recognized as risks factors for Alzheimer’s disease (AD) and early conversion from mild cognitive impairment (MCI) to dementia. While neuroimaging research in AD has focused on brain atrophy, metabolic function or amyloid deposition, little attention has been paid to the effect of cerebrovascular disease to cognitive decline. To investigate the correlation of brain atrophy and white matter lesions with cognitive decline in AD, MCI, and control subjects. Patients with AD and MCI, and healthy subjects were included in this study. Subjects had a baseline MRI scan, and baseline and follow-up neuropsychological battery (CERAD). Regional volumes were measured, and white matter lesion segmentation was performed. Correlations between rate of CERAD score decline and white matter lesion load and brain structure volume were evaluated. In addition, voxel-based correlations between baseline CERAD scores and atrophy and white matter lesion measures were computed. CERAD rate of decline was most significantly associated with lesion loads located in the fornices. Several temporal lobe ROI volumes were significantly associated with CERAD decline. Voxel-based analysis demonstrated strong correlation between baseline CERAD scores and atrophy measures in the anterior temporal lobes. Correlation of baseline CERAD scores with white matter lesion volumes achieved significance in multilobar subcortical white matter. Both baseline and declines in CERAD scores correlate with white matter lesion load and gray matter atrophy. Results of this study highlight the dominant effect of volume loss, and underscore the importance of small vessel disease as a contributor to cognitive decline in the elderly.