Assessing the onset of structural change in familial Alzheimer's disease
Assessing the onset of structural change in familial Alzheimer's disease
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DOI：
10.1002/ana.10424
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发表时间：
2003-02-01
影响因子：
11.2
通讯作者：
Rossor, MN
中科院分区：
文献类型：
--
作者：
Schott, JM;Fox, NC;Rossor, MN
阿尔茨海默病（Alzheimer's disease，AD）不可避免地表现为局部和整体性脑萎缩。我们评估了家族性AD患者在出现症状期间的脑结构体积和萎缩率。5例症状前AD患者和20例对照者每年进行两次或更多次体积MRI脑扫描。测量了脑、脑室、颞叶、脑丘和内嗅皮质（EC）的体积。从连续扫描中计算体积变化率。患者和对照组之间的全脑、颞叶或脑室容积的基线测量值无显著差异;患者内侧颞叶结构（包括小脑顶和EC）的平均体积降低16.6%（95%置信区间[CI]，3.3-28.0%）。与对照组相比，患者的脑、颞叶、海马和EC的萎缩率显著增加（p < 0.05）。患者的平均肌萎缩率比对照组高5.1%（95%CI，3.0-7.1%）。后向线性外推提示内侧颞叶萎缩开始于发病前3.5年（95%CI，0.7-7.5年），当时所有患者均无症状。我们的结论是，增加内侧颞叶萎缩率是AD的早期和显着的特点，病理性萎缩可能是发生前几年的症状。
Regional and global cerebral atrophy are inevitable features of Alzheimer's disease (AD). We assessed volumes and atrophy rates of brain structures in patients with familial AD during the period that they developed symptoms. Five patients with presymptomatic AD and 20 controls had two or more annual volumetric MRI brain scans. Volumes of brain, ventricles, temporal lobes, hippocampi, and entorhinal cortices (ECs) were measured. Rates of volume change were calculated from serial scans. There were no significant differences in baseline measures of whole brain, temporal lobe, or ventricular volume between patients and controls; averaged volumes of medial temporal lobe structures (both hippocampi and ECs) were 16.6% (95% confidence interval [CI], 3.3-28.0%) lower in patients. Atrophy rates for brain, temporal lobe, hippocampus, and EC were significantly increased in patients compared with controls (p < 0.05). Averaged atrophy rates from both hippocampi and ECs were 5.1% (95% CI, 3.0-7.1%) greater in patients than controls. Linear extrapolation backward suggested medial temporal lobe atrophy commenced 3.5 years (95% CI, 0.7-7.5 years) before Onset, when all patients were asymptomatic. We conclude that increased medial temporal lobe atrophy rates are an early and distinguishing feature of AD and that pathological atrophy probably is occurring several years before the onset of symptoms.