Hippocampal volumetry in Alzheimer's disease with coexistent cerebral small vessel disease
Hippocampal volumetry in Alzheimer's disease with coexistent cerebral small vessel disease
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海马容积测定在阿尔茨海默病合并脑小血管疾病中的应用
DOI：
10.1016/j.jalz.2012.05.440
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
S. Black
中科院分区：
文献类型：
--
作者：
G. Schwindt;S. Nestor;S. Black
研究背景老年人脑小血管病（SVD）多表现为白色高信号，在T2/PD和FLAIR MRI上表现为高信号区。SVD在痴呆症中更为常见，通常与阿尔茨海默病（AD）共存。然而，SVD和AD之间的病理相互作用仍然不确定。海马容量测定法提供了AD进展的敏感指标，并且可能在AD和叠加SVD患者中受到不同的影响。目的：为了确定海马萎缩的程度与AD+ SVD的人相比，AD只，轻度认知功能障碍（MCI）和正常老年人controls.MethodsSubjects选择从阿尔茨海默氏病神经影像学倡议1（ADNI-1）和两个正在进行的痴呆症研究在Sunnybrook健康科学中心，多伦多，加拿大。从两项Sunnybrook研究中获得了21例可能/很可能AD（NINCDS-ADRDA标准）、21例AD+ SVD和25例NC患者。从ADNI-1中选择MCI患者400例，AD患者200例，NC患者228例。收集所有ADNI-1参与者的处理过的1.5 T T1-MPGR MRI，并在3.0 T GE扫描仪上采集所有Sunnybrook受试者的高分辨率T1 SPGR MRI。使用全自动海马分割工具标记海马体积。该技术基于多模板配准方案，使用高级归一化工具同构配准算法。还收集了简易精神状态检查（MMSE）评分和人口统计学数据。所有分析均合并双侧海马体积。结果AD组海马体积显著小于AD+ SVD组（P<0. 001）、MCI组（P<0. 001）和NC组（P<0. 001）（表1）。AD+ SVD组的海马体积显著小于MCI组（P< 0.001）和NC组（P< 0.001）（表1）。AD组MMSE评分显著低于AD+ SVD组（P< 0.01）、MCI组（P< 0.01）和NC组（P< 0.001），而AD+ SVD组MMSE评分显著低于MCI组（P< 0.001）和NC组（P< 0.001）（表1）。
BackgroundIn elders, cerebral small vessel disease (SVD) commonly presents as white matter hyperintensities that appear as regions of hyperintense signal on T2/PD and FLAIR MRI. SVD is even more common in dementia, often coexisting with Alzheimer's disease (AD). However, the pathological interactions between SVD and AD remain uncertain. Hippocampal volumetry provides a sensitive measure of AD progression and may be affected differentially in persons with AD and superimposed SVD. Objective: To determine the extent of hippocampal atrophy in persons with AD+ SVD in comparison to AD only, mild cognitive impairment (MCI) and normal elderly controls (NC).MethodsSubjects were selected from the Alzheimer's disease neuroimaging initiative 1 (ADNI-1) and from two ongoing dementia studies at Sunnybrook Health Sciences Centre, Toronto, Canada. Twenty-one patients with possible/probable AD (NINCDS-ADRDA criteria), 21 AD+ SVD, and 25 NC were acquired form the two Sunnybrook studies. Four hundred persons with MCI, 200 with AD and 228 NC were selected from the ADNI-1. Processed 1.5 T T1-MPRAGE MRIs were collected for all ADNI-1 participants and high-resolution T1 SPGR MRI were acquired on a 3.0 T GE Scanner for all Sunnybrook subjects. A fully-automatic hippocampal segmentation tool was used to label hippocampal volumes. The technique was based on a multi-template registration scheme, using the Advanced Normalization Tool diffeomorphic registration algorithm. Mini Mental State Exam (MMSE) scores and demographic data were also collected. Bilateral hippocampal volumes were combined for all analyses. A one-way ANOVA and post-hoc Student-Newman-Keuls test were used to compute all group-wise differences.ResultsThe AD group had significantly smaller hippocampal volumes in comparison to AD+ SVD (P< 0.001), MCI (P< 0.001) and NC (P< 0.001)(Table1). The AD+ SVD group had significantly smaller hippocampal volumes than both MCI (P< 0.001) and NC groups (P< 0.001)(Table1). The AD group had significantly lower MMSE scores in comparison to AD+ SVD (P< 0.01), MCI (P< 0.01) and NC (P< 0.001), while the AD+ SVD group had significantly lower MMSE scores compared to MCI (P< 0.001) and NC (P< 0.001)(Table1).