The cortical signature of prodromal AD Regional thinning predicts mild AD dementia
The cortical signature of prodromal AD Regional thinning predicts mild AD dementia
复制标题
DOI：
10.1212/01.wnl.0000340981.97664.2f
复制
发表时间：
2009-03-24
期刊：
影响因子：
9.9
通讯作者：
Dickerson, Bradford C.
中科院分区：
文献类型：
--
作者：
Bakkour, Akram;Morris, John C.;Dickerson, Bradford C.
目的：我们以前使用探索性分析在整个皮层，以确定轻度阿尔茨海默病（AD）是可靠的相关性与特定的边缘和关联区域的皮质信号变薄。在这里，我们调查了是否AD相关的大脑皮层变薄的签名是存在于个人可疑的AD痴呆症（QAD），以及是否更大程度的区域大脑皮层变薄预测轻度AD dementions.Methods：参与者包括49名老年人与轻度损害符合轻度认知功能障碍（临床痴呆症评级[CDR] = 0.5）在结构MRI扫描的时间。皮质厚度测量在9个区域的利益（ROI）确定以前从轻度AD和controls.Results患者的比较：纵向临床随访显示，20名参与者转换为轻度AD痴呆（进展），而29个保持稳定（nonprogressors）约2.5年后扫描。在基线时，QAD参与者的皮质变薄程度比通常在轻度AD中看到的要轻，CDR盒总和与颞叶和顶叶ROI的厚度相关。与非进展者相比，进展者显示颞叶和顶叶变薄。使用接收器操作特征曲线，这些区域的总测量的厚度预测进展为轻度AD与83%的灵敏度和65% specificity.Conclusions：已知受阿尔茨海默病（AD）影响的特定皮质区变薄是可检测的个人可疑AD痴呆症（QAD）和预测转换为轻度AD痴呆症。这种方法可能是有用的，以确定个人在相对较高的风险，即将从QAD进展到轻度AD痴呆，这可能是在临床试验中的价值。神经病学（R）2009; 72：1048-1055
Objective: We previously used exploratory analyses across the entire cortex to determine that mild Alzheimer disease (AD) is reliably associated with a cortical signature of thinning in specific limbic and association regions. Here we investigated whether the cortical signature of AD-related thinning is present in individuals with questionable AD dementia (QAD) and whether a greater degree of regional cortical thinning predicts mild AD dementia.Methods: Participants included 49 older adults with mild impairment consistent with mild cognitive impairment (Clinical Dementia Rating [CDR] = 0.5) at the time of structural MRI scanning. Cortical thickness was measured in nine regions of interest (ROIs) identified previously from a comparison of patients with mild AD and controls.Results: Longitudinal clinical follow-up revealed that 20 participants converted to mild AD dementia (progressors) while 29 remained stable (nonprogressors) approximately 2.5 years after scanning. At baseline, QAD participants showed a milder degree of cortical thinning than typically seen in mild AD, and CDR Sum-of-Boxes correlated with thickness in temporal and parietal ROIs. Compared to nonprogressors, progressors showed temporal and parietal thinning. Using receiver operating characteristic curves, the thickness of an aggregate measure of these regions predicted progression to mild AD with 83% sensitivity and 65% specificity.Conclusions: Thinning in specific cortical areas known to be affected by Alzheimer disease (AD) is detectable in individuals with questionable AD dementia (QAD) and predicts conversion to mild AD dementia. This method could be useful for identifying individuals at relatively high risk for imminent progression from QAD to mild AD dementia, which may be of value in clinical trials. Neurology (R) 2009; 72: 1048-1055