Using voxel-based morphometry to map the structural changes associated with rapid conversion in MCI:: A longitudinal MRI study
Using voxel-based morphometry to map the structural changes associated with rapid conversion in MCI:: A longitudinal MRI study
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DOI：
10.1016/j.neuroimage.2005.05.015
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发表时间：
2005-10-01
期刊：
影响因子：
5.7
通讯作者：
Baron, JC
中科院分区：
文献类型：
--
作者：
Chételat, G;Landeau, B;Baron, JC
捕捉与从轻度认知障碍（MCI）向临床可能的阿尔茨海默病（AD）转化相关的灰质（GM）萎缩动态将具有相当大的研究意义。在这项前瞻性研究中，我们使用了一种新的基于纵向体素的方法来绘制MCI患者随时间推移的灰质损失进展情况，并将转化者与未转化者进行了比较。对18名遗忘型MCI患者进行了为期预先确定的18个月的随访，并根据美国国立神经病学与卒中研究所和阿尔茨海默病及相关疾病协会（NINCDS - ADRDA）可能的AD标准判断是否转化。每位患者在进入研究时以及18个月后都接受了高分辨率T1加权容积磁共振成像扫描。我们使用了一种优化的基于体素的形态测量学（VBM）方案来比较转化者和未转化者的基线成像数据。此外，为了绘制从基线到随访评估的灰质损失情况，我们使用了一种专门为纵向研究设计的改良的基于体素的形态测量学（VBM）程序。在随访期结束时，有7名患者转化为可能的AD。转化者中基线灰质值较低的区域主要包括海马体、海马旁回皮质以及舌回和梭状回。在18个月的随访期内，转化者和未转化者共同出现的显著灰质损失区域包括颞叶新皮质、海马旁回皮质、眶额叶和顶下区域以及左侧丘脑。然而，在海马区域、颞下回和颞中回、后扣带回以及楔前叶，转化者相对于未转化者的灰质损失明显更大。这种加速萎缩可能是由于神经原纤维缠结的积累以及诸如后扣带回功能改变等并行的病理过程所致。纵向评估MCI中灰质变化的能力为更好地理解阿尔茨海默病的病理过程以及监测治疗对大脑结构的影响提供了新的视角。（C）2005年爱思唯尔公司。保留所有权利。
Capturing the dynamics of gray matter (GM) atrophy in relation to the conversion from mild cognitive impairment (MCI) to clinically probable Alzheimer's disease (AD) would be of considerable interest. In this prospective study we have used a novel longitudinal voxel-based method to map the progression of GM loss in MCI patients over time and compared converters to non-converters. Eighteen amnestic MCI patients were followed-up for a predefined fixed period of 18 months and conversion was judged according to NINCDS-ADRDA criteria for probable AD. Each patient underwent a high-resolution T1-weighted volume MRI scan both at entry in the study and 18 months later. We used an optimal VBM protocol to compare baseline imaging data of converters to those of non-converters. Moreover, to map GM loss from baseline to follow-up assessment, we used a modified voxel-based morphometry (VBM) procedure specially designed for longitudinal studies. At the end of the follow-up period, seven patients had converted to probable AD. Areas of lower baseline GM value in converters mainly included the hippocampus, parahippocampal cortex, and lingual and fusiform gyri. Regions of significant GM loss over the 18-month follow-up period common to both converters and non-converters included the temporal neocortex, parahippocampal cortex, orbitofrontal and inferior parietal areas, and the left thalamus. However, there was significantly greater GM loss in converters relative to non-converters in the hippocampal area, inferior and middle temporal gyros, posterior cingulate, and precuneus. This accelerated atrophy may result from both neurofibrillary tangles accumulation and parallel pathological processes such as functional alteration in the posterior cingulate. The ability to longitudinally assess GM changes in MCI offers new perspectives to better understand the pathological processes underlying AD and to monitor the effects of treatment on brain structure. (C) 2005 Elsevier Inc. All rights reserved.