Quantifying change in individual subjects affected by frontotemporal lobar degeneration using automated longitudinal MRI volumetry
Quantifying change in individual subjects affected by frontotemporal lobar degeneration using automated longitudinal MRI volumetry
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DOI：
10.1002/hbm.21304
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发表时间：
2012-07-01
影响因子：
4.8
通讯作者：
Huppertz, Hans-Juergen
中科院分区：
文献类型：
--
作者：
Frings, Lars;Mader, Irina;Huppertz, Hans-Juergen
一种新的方法，自动磁共振成像容量测定法被用来研究区域萎缩和疾病进展的患者额颞叶变性（FTLD）的重复MRI测量。17例临床诊断的FTLD患者的59个结构MRI数据集以6个月的间隔在长达30个月的时间内获得，并与30名年龄匹配的健康对照组的数据进行比较。患者进一步分为行为变异型FTLD（bvFTLD），进行性非流利性失语症（PNFA）和语义性痴呆（SemD）。基于SPM 5算法和概率脑图谱，采用基于体素的体积测量法测定额叶（FL）和颞叶（TL）的灰质（GM）体积。MRI容量测定显示FTLD患者的额叶和颞叶GM萎缩，并随时间进一步进展。在SemD中发现TL体积的显著侧不对称性。TL与FL体积的比值在SemD中显著降低，在bvFTLD中增加。使用该比值，可以正确区分6/7例SemD患者和5/6例bvFTLD患者。bvFTLD和SemD的TL/FL比值在仅6个月的时间跨度内进一步显著偏离。SemD中每6个月的颞部GM丢失率为34%，bvFTLD中每6个月的额部GM丢失率为2.5%，因此明显超过健康老年受试者中已发表的脑容量丢失。该研究提供了一种完全自动化的、不依赖于年龄的局部萎缩体积评估，可以区分FTLD亚组。即使在6个月这样短的时间间隔内，它对萎缩进展的敏感性也可能有利于未来的临床试验作为治疗结果的衡量标准。^Brain Mapp，2011. (C)2011 Wiley-Liss，Inc.
A novel method of automated MRI volumetry was used to study regional atrophy and disease progression in repeated MRI measurements of patients with frontotemporal lobar degeneration (FTLD). Fifty-nine structural MRI data sets of 17 clinically diagnosed FTLD patients were acquired over up to 30 months in intervals of 6 months and compared with data of 30 age-matched healthy controls. Patients were further subgrouped into behavioral variant FTLD (bvFTLD), progressive nonfluent aphasia (PNFA), and semantic dementia (SemD). Gray matter (GM) volumes of frontal lobes (FL) and temporal lobes (TL) were determined by voxel-based volumetry based on SPM5 algorithms and a probabilistic brain atlas. MRI volumetry revealed frontal and temporal GM atrophy across FTLD patients, with further progression over time. Significant side asymmetry of TL volumes was found in SemD. The ratio of TL to FL volumes was significantly reduced in SemD and increased in bvFTLD. Using this ratio, 6/7 SemD patients and 5/6 bvFTLD patients could be correctly differentiated. TL/FL ratios in bvFTLD and SemD further diverged significantly over a time span of only 6 months. Rates of temporal GM loss per 6 months were 34% in SemD, and 2.5% for frontal GM loss in bvFTLD, and thereby clearly exceeded published cerebral volume loss in healthy elderly subjects. The study presents a fully automated, observer-independent volumetric assessment of regional atrophy which allows differentiation of FTLD subgroups. Its sensitivity for atrophy progressioneven in such short intervals like 6 monthsmight benefit future clinical trials as treatment outcome measure. Hum Brain Mapp, 2011. (C) 2011 Wiley-Liss, Inc.