Posterior Atrophy and Medial Temporal Atrophy Scores Are Associated with Different Symptoms in Patients with Alzheimer's Disease and Mild Cognitive Impairment.
Posterior Atrophy and Medial Temporal Atrophy Scores Are Associated with Different Symptoms in Patients with Alzheimer's Disease and Mild Cognitive Impairment.
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DOI：
10.1371/journal.pone.0137121
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Fuh JL
中科院分区：
文献类型：
--
作者：
Hsu JL;Lee WJ;Liao YC;Lirng JF;Wang SJ;Fuh JL
阿尔茨海默病（AD）和轻度认知障碍（MCI）患者中，后部萎缩（PA）和内侧颞叶萎缩（MTA）的发生是否与认知和非认知症状相关尚不清楚。来自医疗中心门诊的可能患有AD和MCI的患者接受注意力、记忆力、语言、执行功能评估和简易精神状态检查（MMSE）。痴呆的严重程度通过临床痴呆评定（CDR）总和框（CDR-SB）来评定。还应用了神经精神量表（NPI）的激越/攻击和情绪症状子量表。对磁共振成像（MRI）的MTA、PA和白色高信号（WMH）评分进行目视评分。我们招募了129名AD和31名MCI患者（平均年龄78.8岁，48%为女性）。AD组MMSE评分、记忆、语言和执行功能均较MCI组显著降低（P < 0.01）。与MCI相比，MTA和PA评分反映了AD的显著萎缩;然而，WMH评分没有差异。MTA评分与额叶、顶枕叶和整体WMH评分显著相关（p < 0.01），PA评分与顶枕叶和颞叶WMH评分显著相关（p < 0.01）。校正年龄、教育程度、APOE 4基因和诊断组协变量后，MTA评分与MMSE和CDR-SB显著相关，而右侧PA评分与NPI激越/攻击分量表显著相关（p < 0.01）。局部萎缩与AD和MCI患者的不同症状有关。PA评分可作为非认知症状的补充措施。
Whether the occurrence of posterior atrophy (PA) and medial temporal lobe atrophy (MTA) was correlated with cognitive and non-cognitive symptoms in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients are unclear. Patients with probable AD and MCI from a medical center outpatient clinic received attention, memory, language, executive function evaluation and Mini-Mental Status Examination (MMSE). The severity of dementia was rated by the Clinical Dementia Rating (CDR) Sum of Box (CDR-SB). The neuropsychiatric inventory (NPI) subscale of agitation/aggression and mood symptoms was also applied. Magnetic resonance imaging (MRI) was scored visually for the MTA, PA and white matter hyperintensity (WMH) scores. We recruited 129 AD and 31 MCI (mean age 78.8 years, 48% female) patients. MMSE scores, memory, language and executive function were all significantly decreased in individuals with AD than those with MCI (p < 0.01). MTA and PA scores reflected significant atrophy in AD compared to MCI; however, the WMH scores did not differ. The MTA scores were significantly correlated with the frontal, parieto-occipital and global WMH scores (p < 0.01) while the PA scores showed a correlation with the parieto-occipital and temporal WMH scores (p < 0.01). After adjusting for age, education, APOE4 gene and diagnostic group covariates, the MTA scores showed a significant association with MMSE and CDR-SB, while the right side PA scores were significantly associated with NPI-agitation/aggression subscales (p < 0.01). Regional atrophy is related to different symptoms in patients with AD or MCI. PA score is useful as a complementary measure for non-cognitive symptom.