Cerebral Volumetric Correlates of Apathy in Alzheimer's Disease and Cognitively Normal Older Adults: Meta-Analysis, Label-Based Review, and Study of an Independent Cohort.
Cerebral Volumetric Correlates of Apathy in Alzheimer's Disease and Cognitively Normal Older Adults: Meta-Analysis, Label-Based Review, and Study of an Independent Cohort.
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DOI：
10.3233/jad-215316
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发表时间：
2022
影响因子：
4
通讯作者：
Li, Chiang-Shan R.
中科院分区：
文献类型：
--
作者：
Chaudhary, Shefali;Zhornitsky, Simon;Chao, Herta H.;van Dyck, Christopher H.;Li, Chiang-Shan R.
关键词：
影响近一半的阿尔茨海默病（AD）患者，冷漠与较高的发病率和生活质量降低有关。基底神经节和皮质萎缩与冷漠有关。然而，研究结果在不同的研究中存在差异，并且不清楚冷漠的子领域是否可能涉及不同的神经解剖学相关性。我们进行了荟萃分析和基于标签的文献综述。此外，根据已发表的基于体素的形态测定法，我们的目的是在一个独立的队列中证实19例AD/轻度认知障碍患者和25例健康对照（HC）的冷漠评价量表（AES）评估的结果。对167例AD和56例HC的荟萃分析显示，在冷漠中，基底节灰质体积（GMV）向更小的方向收敛。结果表明，AD冷漠症患者的扣带回前部、壳核、额下回、颞中回均萎缩。在独立队列中，小体积校正，右壳核和MTG显示GMV与AES总分、行为和情绪评分呈负相关，右IFG与情绪分项评分呈负相关（p<0.05 FWE校正），控制年龄、教育、颅内总体积和抑郁。以简易精神状态检查量表评分作为协变量，右侧壳核GMV与行为和情绪分项评分、右侧MTG GMV与总分和情绪分项评分、右侧IFG GMV与情绪分项评分的相关性均显著。这些发现共同支持了右壳核、MTG和IFG萎缩在AD相关冷漠中的作用，可能独立于认知障碍和抑郁，并提示冷漠的潜在不同体积相关性。
Affecting nearly half of the patients with Alzheimer’s Disease (AD), apathy is associated with higher morbidity and reduced quality of life. Basal ganglia and cortical atrophy have been implicated in apathy. However, the findings have varied across studies and left unclear whether subdomains of apathy may involve distinct neuroanatomical correlates. We performed a meta-analysis and label-based review of the literature. Further, following published routines of voxel-based morphometry, we aimed to confirm the findings in an independent cohort of 19 patients with AD/mild cognitive impairment and 25 healthy controls (HC) evaluated with the apathy evaluation scale (AES). The meta-analysis of 167 AD and 56 HC showed convergence toward smaller basal ganglia gray matter volume (GMV) in apathy. The label-based review showed anterior cingulate, putamen, insula, inferior frontal gyrus (IFG) and middle temporal gyrus (MTG) atrophy in AD apathy. In independent cohort, with small-volume-correction, the right putamen and MTG showed GMVs in negative correlation with AES total, behavioral, and emotional scores, and right IFG with emotional subscore (p<0.05 FWE-corrected), controlling for age, education, total intracranial volume, and depression. With the Mini-Mental-State-Exam scores included as an additional covariate, the correlation of right putamen GMV with behavioral and emotional subscore, right MTG GMV with total and emotional subscore, and of right IFG GMV with emotional subscore were significant. The findings together support a role of right putamen, MTG and IFG atrophy in AD associated apathy, potentially independent of cognitive impairment and depression, and suggest potentially distinct volumetric correlates of apathy.