Brain regions associated with anosognosia for memory disturbance in Alzheimer's disease: a magnetic resonance imaging study.
Brain regions associated with anosognosia for memory disturbance in Alzheimer's disease: a magnetic resonance imaging study.
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DOI：
10.2147/ndt.s139177
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发表时间：
2017
影响因子：
3.2
通讯作者：
Narumoto J
中科院分区：
文献类型：
--
作者：
Fujimoto H;Matsuoka T;Kato Y;Shibata K;Nakamura K;Yamada K;Narumoto J
阿尔茨海默病（AD）患者通常不知道他们的认知症状和医学诊断。术语“病感失认症”用于指示对一个人的疾病或障碍的普遍缺乏意识。AD病感失认的神经基础尚不清楚。由于记忆障碍的病感失认可能是AD的初始体征，因此确定神经相关性很重要。本研究旨在探讨轻度AD患者记忆障碍的病感失认特征及其神经相关性。受试者是49例轻度AD患者，他们参加了一项回顾性横断面研究。没有患者接受过胆碱酯酶抑制剂、美金刚或精神药物治疗。所有患者均接受了磁共振成像（MRI）检查。根据患者及其照顾者的问卷评分差异评估记忆障碍的病感失认。采用基于体素的方法分析结构MRI数据，以探讨病感失认症和脑萎缩之间的关系。使用统计参数映射软件来探索神经相关性。在图像分析中，进行多元回归分析，以检查疾病感缺失评分与区域灰质体积之间的关系。年龄、受教育年限和颅内总容积作为协变量输入。记忆障碍的病感失认评分与左侧额上级回灰质体积呈显著负相关。左侧上级额回参与记忆障碍的病感失认，而内侧颞叶（通常在轻度AD中受损）与病感失认无关。左额上级回可能是轻度AD病感缺失的重要部位。
Patients with Alzheimer’s disease (AD) are frequently unaware of their cognitive symptoms and medical diagnosis. The term “anosognosia” is used to indicate a general lack of awareness of one’s disease or disorder. The neural substrate underlying anosognosia in AD is unclear. Since anosognosia for memory disturbance might be an initial sign of AD, it is important to determine the neural correlates. This study was designed to investigate the characteristics and neural correlates of anosognosia for memory disturbance in patients with mild AD. The subjects were 49 patients with mild AD who participated in a retrospective cross-sectional study. None of the patients had been treated with cholinesterase inhibitors, memantine, or psychotropic drugs. All patients underwent magnetic resonance imaging (MRI). Anosognosia for memory disturbance was assessed based on the discrepancy between questionnaire scores of patients and their caregivers. Structural MRI data were analyzed to explore the association between anosognosia and brain atrophy, using a voxel-based approach. Statistical parametric mapping software was used to explore neural correlations. In image analysis, multiple regression analysis was performed to examine the relationship between anosognosia score and regional gray matter volume. Age, years of education, and total intracranial volume were entered as covariates. The anosognosia score for memory disturbance was significantly negatively correlated with gray matter volume in the left superior frontal gyrus. The left superior frontal gyrus was involved in anosognosia for memory disturbance, while the medial temporal lobe, which is usually damaged in mild AD, was not associated with anosognosia. The left superior frontal gyrus might be an important region for anosognosia in mild AD.