Comparison of different MRI brain atrophy, rate measures with clinical disease progression in AD
Comparison of different MRI brain atrophy, rate measures with clinical disease progression in AD
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DOI：
10.1212/01.wnl.0000110315.26026.ef
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发表时间：
2004-02-24
期刊：
影响因子：
9.9
通讯作者：
Petersen, RC
中科院分区：
文献类型：
--
作者：
Jack, CR;Shiung, MM;Petersen, RC
目的：将不同方法测量的序列MRI脑萎缩率与正常老年受试者、轻度认知障碍（MCI）患者和疑似阿尔茨海默病（AD）患者的相应临床变化相关联。研究方法：从马约诊所阿尔茨海默病研究中心和阿尔茨海默病患者登记研究招募了160名受试者。基线时，55例受试者认知正常，41例符合MCI标准，64例符合MCI标准。AD的标准。每例受试者在基线临床评估时接受脑部MRI检查，然后在1至5年后的随访临床评估时再次接受脑部MRI检查。从系列MRI研究中测量了四个结构的体积年变化：海马、内嗅皮层、全脑和脑室。还评估了几种认知测试/评定量表的变化率。在基线时被分类为正常或MCI的受试者可以保持稳定或转换为低功能组。AD受试者被二分为慢进展者和快进展者。结果如下：所有四种萎缩率在转换为MCI或AD的正常受试者中均高于保持稳定的受试者，在转换为AD的MCI受试者中高于保持稳定的受试者，并且在快速AD进展者中高于缓慢AD进展者。一般而言，MRI上的萎缩比特定认知测试/评定量表上的下降更一致。除了一个例外，在疾病的不同阶段，四种MRI率测量与临床恶化的相关性强度没有差异。结论：这些数据支持除了标准临床/心理测量外，还使用系列MRI研究的变化率作为AD疾病进展的替代标志物。在MCI中进行治疗试验所需的估计样本量对于MRI比基于认知测试/评定量表的变化测量小一个数量级。
Objective: To correlate different methods of measuring rates of brain atrophy from serial MRI with corresponding clinical change in normal elderly subjects, patients with mild cognitive impairment (MCI), and patients with probable Alzheimer disease (AD). Methods: One hundred sixty subjects were recruited from the Mayo Clinic Alzheimer's Disease Research Center and Alzheimer's Disease Patient Registry Studies. At baseline, 55 subjects were cognitively normal, 41 met criteria for MCI, and 64 met. criteria for AD. Each subject underwent an MRI examination of the brain at the time of the baseline clinical assessment and then again at the time of a follow-up clinical assessment, I to 5 years later. The annualized changes in volume of four structures were measured from the serial MRI studies: hippocampus, entorhinal cortex, whole brain, and ventricle. Rates of change on several cognitive tests/rating scales were also assessed. Subjects who were classified as normal or MCI at baseline could either remain stable or convert to a lower-functioning group. AD subjects were dichotomized into slow vs fast progressors. Results: All four atrophy rates were greater among normal subjects who converted to MCI or AD than among those who remained stable, greater among MCI subjects who converted to AD than among those who remained stable, and greater among fast than slow AD progressors. In general, atrophy on MRI was detected more consistently than decline on specific cognitive tests/rating scales. With one exception, no differences were found among the four MRI rate measures in the strength of the correlation with clinical deterioration at different stages of the disease. Conclusions: These data support the use of rates of change from serial MRI studies in addition to standard clinical/psychometric measures as surrogate markers of disease progression in AD. Estimated sample sizes required to power a therapeutic trial in MCI were an order of magnitude less for MRI than for change measures based on cognitive tests/rating scales.