Medial temporal atrophy on MRI in normal aging and very mild Alzheimer's disease
Medial temporal atrophy on MRI in normal aging and very mild Alzheimer's disease
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DOI：
10.1212/wnl.49.3.786
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发表时间：
1997-09-01
期刊：
影响因子：
9.9
通讯作者：
Kokmen, E
中科院分区：
文献类型：
--
作者：
Jack, CR;Petersen, RC;Kokmen, E
基于磁共振成像（MRI）的内侧颞叶（MTL）结构体积测量能够区分正常老年对照受试者和中重度阿尔茨海默病（AD）患者。然而，就临床应用而言，一个更重要的问题是该技术区分正常老年对照受试者和处于疾病极轻微阶段的AD患者的能力。我们对126名认知正常的老年对照受试者和94名可能患有AD的患者进行了基于MRI的海马体、海马旁回和杏仁核体积测量。AD的诊断依据美国国立神经疾病与卒中研究所/阿尔茨海默病及相关疾病协会（NINDS/ADRDA）标准，疾病严重程度根据临床痴呆评定量表（CDR）评分进行分类。CDR为0.5的患者被归类为极轻度，CDR为1的为轻度，CDR为2的为中度疾病严重程度。在对照受试者中，各结构的体积随年龄增长而减小，且男性和女性的变化趋势相同。AD患者中各测量的MTL结构体积也随年龄增长而减小。AD患者各MTL结构的体积明显小于对照受试者（p < 0.001）。在几种MTL测量指标中，海马体总体积测量在区分对照受试者和AD患者方面效果最佳。按疾病严重程度，AD患者相对于对照受试者的平均海马体体积如下：极轻度AD（CDR 0.5）比对照均值低1.75个标准差，轻度AD（CDR 1）低1.99个标准差，中度AD（CDR 2）低2.22个标准差。基于MRI的年龄和性别校正的标准化海马体体积测量为AD疾病早期MTL神经解剖学退变提供了一个敏感的标志物。
Magnetic resonance imaging (MRI)-based volumetric measurements of medial temporal lobe (MTL) structures can discriminate between normal elderly control subjects and patients with Alzheimer's disease (AD) of moderate to advanced severity. In terms of clinical utility, however, a more important issue concerns the ability of the technique to differentiate between normal elderly control subjects and AD patients with the very mildest form of the disease. We performed MRI-based volumetric measurements of the hippocampus, parahippocampal gyrus, and amygdala in 126 cognitively normal elderly control subjects and 94 patients with probable AD. The diagnosis of BD was made according to NINDS/ADRDA criteria, and disease severity was categorized by Clinical Dementia Rating (CDR) scores. Patients with CDR 0.5 were classified as very mild, CDR 1 as mild, and CDR 2 as moderate disease severity. Volumes of each structure declined with increasing age in control subjects and did so in parallel for men and women. The volume of each measured MTL structure also declined with age in patients with AD. The volume of each MTL structure was significantly smaller in AD patients than control subjects (p < 0.001). Of the several MTL measures, the total hippocampal volumetric measurements were best at discriminating control subjects from AD patients. The mean hippocampal volumes for AD patients relative to control subjects by severity of disease were as follows: very mild AD (CDR 0.5) -1.75 SD below the control mean, mild AD (CDR 1) -1.99 SD, and moderate AD (CDR 2) -2.22 SD, Age- and gender-adjusted, normalized MRI-based hippocampal volumetric measurements provide a sensitive marker of the MTL neuroanatomic degeneration in AD early in the disease process.