Different regional patterns of cortical thinning in Alzheimer's disease and frontotemporal dementia
Different regional patterns of cortical thinning in Alzheimer's disease and frontotemporal dementia
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DOI：
10.1093/brain/awm016
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发表时间：
2007-04-01
期刊：
影响因子：
14.5
通讯作者：
Weiner, Michael W.
中科院分区：
文献类型：
--
作者：
Du, An-Tao;Schuff, Norbert;Weiner, Michael W.
阿尔茨海默氏病和额颞叶痴呆（FTD）可能很难区分临床，因为重叠的症状。通过MRI测量脑萎缩的体积来区分这两种痴呆只取得了部分成功。MRI测量皮质变薄是否能提高阿尔茨海默病和FTD之间的区分尚不清楚。在这项研究中，我们测量皮质厚度使用一套自动化工具（Freesurfer）重建大脑的皮质表面从T-1加权结构MRI数据在22例阿尔茨海默病患者，19例FTD和23名认知正常的受试者。目的是检测这两种类型痴呆中皮质变薄的特征模式，测试皮质厚度与认知障碍之间的关系，确定皮质厚度测量是否优于皮质体积测量，以区分这些痴呆和正常衰老，并仅基于神经心理学评分改善阿尔茨海默病和FTD的分类。与认知正常的受试者相比，阿尔茨海默病患者的大脑皮层主要在双侧、额叶、顶叶、颞叶和枕叶较薄（P < 0.001），而FTD患者的大脑皮层在双侧、额叶和颞叶较薄，在下顶叶和后扣带回较薄（P < 0.001）。与FTD患者相比，阿尔茨海默病患者双侧顶叶和楔前叶部分区域的皮质较薄（P < 0.001）。阿尔茨海默病患者认知功能障碍与额叶、顶叶和颞叶皮质厚度呈负相关，而FTD患者认知功能障碍与额叶、顶叶和颞叶皮质厚度无显著相关性。在区分正常老化、阿尔茨海默病和FTD方面，皮质厚度测量与皮质体积测量相似。此外，皮质厚度测量显著改善了仅基于神经心理学评分的阿尔茨海默病和FTD之间的分类，包括简易精神状态检查和改良版的线索制作测试。总之，阿尔茨海默病和FTD中皮质变薄的特征模式表明，皮质厚度可能是这些类型痴呆的有用替代标记物。
Alzheimer's disease and frontotemporal dementia (FTD) can be difficult to differentiate clinically because of overlapping symptoms. Distinguishing the two dementias based on volumetric measurements of brain atrophy with MRI has been only partially successful. Whether MRI measurements of cortical thinning improve the differentiation between Alzheimer's disease and FTD is unclear. In this study, we measured cortical thickness using a set of automated tools (Freesurfer) to reconstruct the brain's cortical surface from T-1-weighted structural MRI data in 22 patients with Alzheimer's disease, 19 patients with FTD and 23 cognitively normal subjects. The goals were to detect the characteristic patterns of cortical thinning in these two types of dementia, to test the relationship between cortical thickness and cognitive impairment, to determine if measurement of cortical thickness is better than that of cortical volume for differentiating between these dementias and normal ageing and improving the classification of Alzheimer's disease and FTD based on neuropsychological scores alone. Compared to cognitively normal subjects, Alzheimer's disease patients had a thinner cortex primarily in bilateral, frontal, parietal, temporal and occipital lobes (P < 0.001), while FTD patients had a thinner cortex in bilateral, frontal and temporal regions and some thinning in inferior parietal regions and the posterior cingulate (P < 0.001). Compared to FTD patients, Alzheimer's disease patients had a thinner cortex (P < 0.001) in parts of bilateral parietal and precuneus regions. Cognitive impairment was negatively correlated with cortical thickness of frontal, parietal and temporal lobes in Alzheimer's disease, while similar correlations were not significant in FTD. Measurement of cortical thickness was similar to that of cortical volume in differentiating between normal ageing, Alzheimer's disease and FTD. Furthermore, cortical thickness measurements significantly improved the classification between Alzheimer's disease and FTD based on neuropsychological scores alone, including the Mini-Mental State Examination and a modified version of the Trail-Making Test. In conclusion, the characteristic patterns of cortical thinning in Alzheimer's disease and FTD suggest that cortical thickness may be a useful surrogate marker for these types of dementia.