Major decrease in the volume of the entorhinal cortex in patients with Alzheimer's disease carrying the apolipoprotein E ε4 allele
Major decrease in the volume of the entorhinal cortex in patients with Alzheimer's disease carrying the apolipoprotein E ε4 allele
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DOI：
10.1136/jnnp.65.3.322
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发表时间：
1998-09-01
影响因子：
11
通讯作者：
Soininen, H
中科院分区：
文献类型：
--
作者：
Juottonen, K;Lehtovirta, M;Soininen, H
目的-最近的证据表明，载脂蛋白E（ApoE）等位基因是阿尔茨海默病的危险因素。也有人提出，它与淀粉样蛋白斑块和神经纤维缠结的计数增加有关，而淀粉样蛋白斑块和神经纤维缠结又是最初出现在阿尔茨海默病中的内侧颞叶结构中的神经病理学标志。在这项研究中，影响载脂蛋白E144等位基因的体积内嗅皮质进行了评估，在vivo.Methods -体积内嗅皮质的MR图像上使用最近设计的组织学为基础的协议，在16例阿尔茨海默病与载脂蛋白E144（平均年龄70.4（SD 9.9））、11例无ApoE基因的阿尔茨海默病患者（平均年龄69.1（SD 7.1））和31例年龄和性别匹配的健康正常对照（72.2（SD 3.9））。这些患者符合NINCDS-ADRDA关于可能的阿尔茨海默病的标准，并且处于疾病的轻度至中度阶段。MRI进行了1.5特斯拉磁共振成像和3D技术，允许重建的2.0 mm厚的连续切片垂直于轴的前-后commissure.Results -阿尔茨海默氏病的患者没有ApoE β 4等位基因有萎缩的内嗅皮质，体积减少了27%，与对照组相比。然而，内嗅皮质最显著的萎缩（45%）见于具有ApoE β 4等位基因的阿尔茨海默病患者（p = 0.0001）。与患有阿尔茨海默病的男性患者相比，患有阿尔茨海默病的女性患者中，α 4对内嗅皮质体积的影响尤其突出（p = 0.014）。此外，患者的载脂蛋白E144等位基因有较差的性能比那些没有等位基因。结论-体积MRI测量揭示，载脂蛋白E144与内嗅皮层的萎缩程度在早期阿尔茨海默氏病，这种影响是特别突出的女性患者阿尔茨海默氏病。
Objective - Recent evidence indicates that the apolipoprotein E (ApoE) epsilon 4 allele is a risk factor for developing Alzheimer's disease. It has also been proposed that it is associated with increased counts of amyloid plaques and neurofibrillary tangles that in turn are neuropathological hallmarks initially appearing in the medial temporal lobe structures in Alzheimer's disease. In this study, the effect of the ApoE epsilon 4 allele on the volume of the entorhinal cortex was evaluated in vivo.Methods - The volume of the entorhinal cortex was measured on MR images using a recently designed histology based protocol in 16 patients with Alzheimer's disease with ApoE epsilon 4 (mean age 70.4 (SD 9.9)), 11 patients with Alzheimer's disease without ApoE epsilon 4 (mean age 69.1 (SD 7.1)), and in 31 healthy age and sex matched normal controls (72.2 (SD 3.9)). The patients met the NINCDS-ADRDA criteria for probable Alzheimer's disease and were in mild to moderate stages of the disease. MRI was performed with a 1.5 Tesla Magnetom and a 3D technique permitting the reconstruction of 2.0 mm thick contiguous slices perpendicular to the axis of the anterior-posterior commissure.Results - The patients with Alzheimer's disease without the ApoE epsilon 4 allele had atrophy in the entorhinal cortex, the volume was reduced by 27% compared with control subjects. However, the most prominent shrinkage (45%) in the entorhinal cortex was seen in patients with Alzheimer's disease with the ApoE epsilon 4 allele (p = 0.0001). The effect of epsilon 4 on the entorhinal cortex volume was especially prominent in female patients with Alzheimer's disease compared to male patients with Alzheimer's disease (p = 0.014). Additionally, patients with the ApoE epsilon 4 allele had inferior performance in verbal and visual memory functions than those without the allele.Conclusions - Volumetric MRI measurements disclose that ApoE epsilon 4 is associated with the degree of atrophy in the entorhinal cortex in early Alzheimer's disease, this effect being especially prominent in female patients with Alzheimer's disease.