Voxel-based morphometric comparison between early- and late-onset mild Alzheimer's disease and assessment of diagnostic performance of z score images.
Voxel-based morphometric comparison between early- and late-onset mild Alzheimer's disease and assessment of diagnostic performance of z score images.
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发表时间：
2005-02
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通讯作者：
K. Ishii;T. Kawachi;Hiroki Sasaki;A. Kono;T. Fukuda;Yoshio Kojima;E. Mori
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作者：
K. Ishii;T. Kawachi;Hiroki Sasaki;A. Kono;T. Fukuda;Yoshio Kojima;E. Mori
背景和目的：基于体素的形态测量(VBM)用于检测脑萎缩，允许在两组之间比较图像中每个体素的局部灰质浓度。我们试图通过MR成像和VBM描绘与阿尔茨海默病(AD)发病相关的大脑灰质丢失的特定模式，并用Z分数图像评估VBM的诊断性能。方法对30例不同发病年龄的轻度阿尔茨海默病患者进行检测。早发组和晚发组的平均年龄分别为60.2±5.2岁和71.5±-2.6岁。对照组为年龄匹配的健康志愿者。用VBM检查早发和晚发AD患者的灰质损失区。通过计算受试者工作特征曲线下面积(A(Z))来评价VBM方法获得的Z评分图像在患者和对照组中的诊断性能。结果AD组和AD组大鼠双侧颞叶内侧灰质明显减少。此外，早发组在双侧顶叶、后扣带回皮质和楔前区域有更严重的灰质丢失。早发组(A(Z)=0.9435)和晚发组(A(Z)=0.9018)的Z评分图像的诊断效果无差异。结论早发型AD患者与晚发型AD患者在局部灰质丢失的模式上存在差异。早发性AD患者顶颞部和后扣带回灰质丢失，而晚发性AD患者则未见。VBM获得的Z-Score图像对轻度AD有较好的诊断性能，可用于临床检查中对轻度AD的检测。
BACKGROUND AND PURPOSE Voxel-based morphometry (VBM), used for detecting brain atrophy, permits comparison of local gray matter concentration at every voxel in an image between two groups. We sought to delineate the specific patterns of cerebral gray matter loss with regard to onset of Alzheimer's disease (AD) by using MR imaging and VBM and to evaluate the diagnostic performance of VBM with Z score images. METHODS Two groups of 30 patients with mild AD of different ages of onset were examined. Mean ages in the early- and late-onset groups were 60.2 +/- 5.2 and 71.5 +/- 2.6 years, respectively. Control subjects were aged-matched healthy volunteers. Regions of gray matter loss in early- and late-onset AD were examined with VBM. Diagnostic performance of Z score images obtained with the VBM method was evaluated in patients and control subjects by calculating the area under the receiver operating characteristic curve (A(z)). RESULTS Both AD groups had significantly reduced gray matter in the bilateral medial temporal regions. In addition, the early-onset group had more severe gray matter loss in the bilateral parietal and posterior cingulate cortices and precuneus region. No difference was noted in diagnostic performance of Z score images between the early- (A(z) = 0.9435) and late-onset (A(z) = 0.9018) groups. CONCLUSION Differences were noted in the patterns of regional gray matter loss in patients with early-onset AD versus those with late-onset AD. Parietotemporal and posterior cingulate gray matter loss was found in early-onset AD but not in late-onset AD. Z score images obtained with VBM had a great diagnostic performance for mild AD and can be applied for detecting mild AD in clinical examinations.