The interactive effect of demographic and clinical factors on hippocampal volume: A multicohort study on 1958 cognitively normal individuals
The interactive effect of demographic and clinical factors on hippocampal volume: A multicohort study on 1958 cognitively normal individuals
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DOI：
10.1002/hipo.22721
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发表时间：
2017-06-01
期刊：
影响因子：
3.5
通讯作者：
Westman, Eric
中科院分区：
文献类型：
--
作者：
Ferreira, Daniel;Hansson, Oskar;Westman, Eric
阿尔茨海默病的特征是海马萎缩。其他因素也会影响海马体积，但它们的相互作用尚未在认知健康的个体中进行过研究。本研究的目的是评估关键的人口统计学和临床因素对海马体积的相互作用，与以前的研究经常调查这些因素在一个单独的方式。此外，研究ADNI、Aibl和AddNeuroMed的对照组与5个基于人群的队列的可比性。本研究纳入了1958名受试者（100名AddNeuroMed、226名ADNI、155名Aibl、59名BRC、295名GENIC、279名BioFiNDER、398名PIVUS和446名SNAC-K）。使用ANOVA和随机森林检验人口统计学-临床变量的队列间差异。采用多元回归分析研究人口统计学-临床变量对海马体积的影响。用协方差分析分析是否队列间的人口统计学-临床变量的差异解释了海马体积的队列间差异。年龄和全脑萎缩是解释海马体积变异性的最重要变量。这些变量不仅本身重要，而且与性别、教育、MMSE和颅内总体积相互作用。AddNeuroMed、ADNI和Aibl在几个对海马体积有显著影响的人口统计学-临床变量上与基于人群的队列不同。认知正常的个体海马体积的变异性很高。以前倾向于与疾病机制相关的差异也可以部分解释为与疾病无关的人口统计学和临床因素。此外，认知正常的个体，特别是来自ADNI和Aibl的个体，并不能代表一般人群。这些发现可能对未来的研究和临床试验具有重要意义，将成像生物标志物转化为普通人群，并验证阿尔茨海默病和痴呆前期阶段的当前诊断标准。
Alzheimer's disease is characterized by hippocampal atrophy. Other factors also influence the hippocampal volume, but their interactive effect has not been investigated before in cognitively healthy individuals. The aim of this study is to evaluate the interactive effect of key demographic and clinical factors on hippocampal volume, in contrast to previous studies frequently investigating these factors in a separate manner. Also, to investigate how comparable the control groups from ADNI, AIBL, and AddNeuroMed are with five population-based cohorts. In this study, 1958 participants were included (100 AddNeuroMed, 226 ADNI, 155 AIBL, 59 BRC, 295 GENIC, 279 BioFiNDER, 398 PIVUS, and 446 SNAC-K). ANOVA and random forest were used for testing between-cohort differences in demographic-clinical variables. Multiple regression was used to study the influence of demographic-clinical variables on hippocampal volume. ANCOVA was used to analyze whether between-cohort differences in demographic-clinical variables explained between-cohort differences in hippocampal volume. Age and global brain atrophy were the most important variables in explaining variability in hippocampal volume. These variables were not only important themselves but also in interaction with gender, education, MMSE, and total intracranial volume. AddNeuroMed, ADNI, and AIBL differed from the population-based cohorts in several demographic-clinical variables that had a significant effect on hippocampal volume. Variability in hippocampal volume in individuals with normal cognition is high. Differences that previously tended to be related to disease mechanisms could also be partly explained by demographic and clinical factors independent from the disease. Furthermore, cognitively normal individuals especially from ADNI and AIBL are not representative of the general population. These findings may have important implications for future research and clinical trials, translating imaging biomarkers to the general population, and validating current diagnostic criteria for Alzheimer's disease and predementia stages.