Atrophy rates accelerate in amnestic mild cognitive impairment
Atrophy rates accelerate in amnestic mild cognitive impairment
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DOI：
10.1212/01.wnl.0000281688.77598.35
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发表时间：
2008-05-06
期刊：
影响因子：
9.9
通讯作者：
Petersen, R. C.
中科院分区：
文献类型：
--
作者：
Jack, C. R., Jr.;Weigand, S. D.;Petersen, R. C.
背景：我们测试了在患有遗忘性轻度认知障碍（aMCI）的个体进展为典型的晚发性阿尔茨海默病（AD）时，脑萎缩率是否会加速。我们纳入了没有进展的aMCI受试者（标记为aMCI- s）和认知正常的老年受试者（CN）的比较。方法：我们研究了46例进展为AD的aMCI患者（标记为aMCI- p）， 46例CN和23例aMCI- s。所有受试者必须做过三次或以上的连续核磁共振扫描。在所有可用的连续MRI扫描中测量每个受试者的脑萎缩率和心室扩张率。相对于受试者进展到临床诊断为阿尔茨海默病（索引日期）的体积变化在aMCI-P中建模。在所有三个临床组中对体积相对于年龄的变化进行建模。结果：aMCI-P组脑室扩张指数前后速率变化（即加速）为1.7 cm(3)/年，脑萎缩加速为5.3 cm(3)/年。随着年龄的增长，三组的脑容量下降，心室容量增加。在aMCI-P中，体积变化随年龄的增加而减慢，在aMCI-S中，体积变化程度较小，但在匹配的CN中，体积变化呈线性变化。在所有aMCI患者中，载脂蛋白E ε 4携带者的萎缩率高于非携带者。结论：随着个体从遗忘性轻度认知障碍（aMCI）发展到典型的晚发性阿尔茨海默病（AD），萎缩的速度加快。年轻的aMCI患者的萎缩率高于老年进展为AD的aMCI患者和未进展的aMCI患者。在70- 90岁的认知正常受试者中，我们没有发现脑萎缩率随年龄变化。
Background: We tested if rates of brain atrophy accelerate in individuals with amnestic mild cognitive impairment (aMCI) as they progress to typical late onset Alzheimer disease (AD). We included comparisons to subjects with aMCI who did not progress (labeled aMCI-S) and also to cognitively normal elderly subjects (CN).Methods: We studied 46 subjects with aMCI who progressed to AD (labeled aMCI-P), 46 CN, and 23 aMCI-S. All subjects must have had three or more serial MRI scans. Rates of brain shrinkage and ventricular expansion were measured across all available serial MRI scans in each subject. Change in volumes relative to the point at which subjects progressed to a clinical diagnosis of AD (the index date) was modeled in aMCI-P. Change in volumes relative to age was modeled in all three clinical groups.Results: In aMCI-P the change in pre to post index rate (i.e., acceleration) of ventricular expansion was 1.7 cm(3)/year, and acceleration in brain shrinkage was 5.3 cm(3)/year. Brain volume declined and ventricular volume increased in all three groups with age. Volume changes decelerated with increasing age in aMCI-P, and to a lesser extent in aMCI-S, but were linear in the matched CN. Among all subjects with aMCI, rates of atrophy were greater in apolipoprotein E epsilon 4 carriers than noncarriers.Conclusions: Rates of atrophy accelerate as individuals progress from amnestic mild cognitive impairment (aMCI) to typical late onset Alzheimer disease (AD). Rates of atrophy are greater in younger than older subjects with aMCI who progressed to AD and subjects with aMCI who did not progress. We did not find that atrophy rates varied with age in 70-to 90-year-old cognitively normal subjects.