In vivo mapping of incremental cortical atrophy from incipient to overt Alzheimer's disease
In vivo mapping of incremental cortical atrophy from incipient to overt Alzheimer's disease
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DOI：
10.1007/s00415-009-5040-7
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发表时间：
2009-06-01
影响因子：
6
通讯作者：
Thompson, Paul M.
中科院分区：
文献类型：
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作者：
Frisoni, Giovanni B.;Prestia, Annapaola;Thompson, Paul M.
进行性脑萎缩被认为是阿尔茨海默病(AD)的标志，证据最确凿。绘制整个严重程度阶段的皮质萎缩的地形图可能有助于识别受影响的神经网络。对20例健康老年人(OH29.1+/-A1.0)、11例早期AD(26.5+/-A2.0)、15例轻度AD(23.5+/-A2.2)和15例中度AD(16.5+/-A2.0)进行了三维磁共振检查。进行皮质模式匹配分析，并计算出以下组之间灰质分布的百分比差异图：IAD与OH，MIAD与IAD，MOAD与MIAD。与OH相比，IAD患者在多突触海马通路(扣带回/脾后和内侧颞叶皮质)和膝下/眶前叶皮质周围的皮质灰质平均丢失9-20%，而在其他新皮质区域的灰质丢失较少，为5%-11%。与IAD相比，MIAD表现为广泛的灰质丢失，平均灰质丢失14-19%，包括直接海马通路(颞极、颞顶联合皮质和前额叶背侧皮质)、感觉运动和视觉皮质，多突触通路区域灰质丢失较少(7-9%)。与MIAD相比，MOAD仅初级感觉运动皮质萎缩较为明显，灰质平均丢失10-11%，其他区域的灰质丢失普遍在10%以下。提示IAD患者多突触海马区通路受累，MOAD患者直接通路、感觉运动和视觉网络受累，感觉运动网络受累。
Progressive brain atrophy is believed to be the Alzheimer's disease (AD) marker with the greatest evidence for validity. Mapping the topography of cortical atrophy throughout the stages of severity may allow the neural networks affected to be identified. Twenty healthy elderly persons (OH, MMSE 29.1 +/- A 1.0), 11 patients with incipient AD (iAD, 26.5 +/- A 2.0), 15 with mild AD (miAD, 23.5 +/- A 2.2), and 15 with moderate AD (moAD, 16.5 +/- A 2.0) underwent 3D magnetic resonance. Cortical pattern matching analysis was performed and maps of percent differences in gray matter distribution were computed between the following groups: iAD versus OH, miAD versus iAD, and moAD versus miAD. Compared to OH, iAD patients exhibited a mean cortical gray matter loss of 9-20% in areas encompassing the polysynaptic hippocampal pathway (posterior cingulate/retrosplenial and medial temporal cortex) and subgenual/orbitofrontal cortices, and a less widespread loss of 5-11% in other neocortical areas. Compared to iAD, miAD featured widespread mean gray matter loss of 14-19% in areas encompassing the direct hippocampal pathway (temporal pole, temporoparietal association cortex, and dorsal prefrontal cortex), sensorimotor, and visual cortex, with a less marked loss (7-9%) in the polysynaptic pathway areas. Compared to miAD, only atrophy in the primary sensorimotor cortex was still relatively marked in moAD, with a mean gray matter loss of 10-11%; the loss in other regions was generally below 10%. These findings suggest that the polysynaptic hippocampal pathway is affected in iAD, the direct pathway and sensorimotor and visual networks are affected in moAD, and the sensorimotor network is affected in moAD.