Brainstem morphological changes in Alzheimer's disease.
Brainstem morphological changes in Alzheimer's disease.
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DOI：
10.1097/wnr.0000000000000362
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发表时间：
2015-05-06
期刊：
影响因子：
1.7
通讯作者：
Lim HK
中科院分区：
文献类型：
--
作者：
Lee JH;Ryan J;Andreescu C;Aizenstein H;Lim HK
由于脑干核团与几个皮层结构相互连接，并调节几种自主，认知和行为功能，因此将脑干置于阿尔茨海默病（AD）进展的重要病理核心中可能是重要的。虽然已经有几个尸检研究报告了AD脑干的神经病理学改变，但还没有AD患者脑干的体内结构神经影像学研究。本研究的目的是探讨AD患者和老年正常对照组之间脑干体积和形状的差异。选择AD患者50例（临床痴呆量表评分≥ 1分）和正常对照组50例，比较两组脑干体积和变形情况。AD患者脑干总体积[（mean ± SD）21007 ± 1640 mm3]较对照组[（mean ± SD）22530 ± 1750 mm3]显著减小（P < 0.001）。此外，AD患者与健康人相比，在中脑对应的脑干后上部存在明显的脑干变形（校正错误发现率P < 0.05）。本研究首次探讨了AD患者脑干体积的变化和变形。这些结构的变化，在中脑区域可能是在脑干功能障碍的神经生物学机制的核心与相关的各种认知和行为症状，如记忆障碍，睡眠，情绪障碍在AD。然而，可能需要进一步的纵向研究来证实这些发现。
As brainstem nuclei are interconnected with several cortical structures and regulate several autonomic, cognitive, and behavioral functions, it might be important to place the brainstem within an important pathologic core in the progression of Alzheimer’s disease (AD). Although there have been several postmortem studies reporting neuropathological alterations of the brainstem in AD, there has been no in-vivo structural neuroimaging study of the brainstem in the patients with AD. The aim of this study was to investigate differences in the brainstem volume and shape between patients with AD and elderly normal controls. Fifty AD patients (the Clinical Dementia Rating Scale ≥ 1) and 50 normal controls were recruited, and the brainstem volumes and deformations were compared between the AD and the controls. Patients with AD showed significant total volume [(mean ± SD) 21007 ± 1640 mm3]reduction in the brainstem compared with the controls [(mean ± SD) 22530 ± 1750 mm3] (P < 0.001). In addition, AD patients showed significant brainstem deformations in the upper posterior brainstem corresponding to the midbrain compared with the healthy individuals (false discovery rate corrected P < 0.05). This study is the first to explore brainstem volume change and deformations in AD. These structural changes in the midbrain areas might be at the core of the underlying neurobiological mechanisms of brainstem dysfunction with relevance to their various cognitive and behavioral symptoms such as memory impairment, sleep, and emotional disturbance in AD. However, further longitudinal studies might be needed to confirm these findings.