Hippocampal volume as an index of Alzheimer neuropathology - Findings from the Nun Study
Hippocampal volume as an index of Alzheimer neuropathology - Findings from the Nun Study
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DOI：
10.1212/wnl.58.10.1476
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发表时间：
2002-05-28
期刊：
影响因子：
9.9
通讯作者：
Snowdon, DA
中科院分区：
文献类型：
--
作者：
Gosche, KM;Mortimer, JA;Snowdon, DA
目标：确定海马体积是否是阿尔茨海默病神经病理学的敏感和特异性指标，无论是否存在认知和记忆障碍。研究方法：对Nun研究的前56名参与者进行死后MRI扫描，使用受试者工作特征曲线下的面积、灵敏度、特异性以及阳性和阴性预测值来评估海马体积在预测阿尔茨海默病神经病理标准的实现和Braak分期差异中的诊断准确性。结果如下：海马体积预测所有56名参与者符合AD的神经病理学标准（p < 0.001）：24名患有痴呆症的姐妹篇（p = 0.036）; 32个没有精神错乱的姐妹篇（p <0.001），8名姐妹篇保持非痴呆但有记忆障碍（p < 0.001），24名姐妹篇在死亡前的最后检查中记忆和认知完整（p = 0.003）。在保持非痴呆状态的个体中，海马体积是比延迟记忆测量更好的AD神经病理学指标。在非痴呆的姐妹篇中，Braak III期和VI期与Braak II期或更低（p = 0.001）可区分。在认知功能完整的个体中，Braak II期的个体可以与I期或更低的个体区分开来（p = 0.025）。结论：海马体的体积测量可能是有用的，在确定非痴呆症的个人谁满足AD的神经病理学标准以及AD的病理阶段，可能是目前的几十年前，最初的临床表现。
Objective: To determine whether hippocampal volume is a sensitive and specific indicator of Alzheimer neuropathology, regardless of the presence or absence of cognitive and memory impairment. Methods: Postmortem MRI scans were obtained for the first 56 participants of the Nun Study who were scanned, The area under receiver operating characteristic curves, sensitivity, specificity, and positive and negative predictive values were used to assess the diagnostic accuracy of hippocampal volume in predicting fulfillment of Alzheimer neuropathologic criteria and differences in Braak staging. Results: Hippocampal volume predicted fulfillment of neuropathologic criteria for AD for all 56 participants (p < 0.001): 24 sisters who were demented (p = 0.036); 32 sisters who remained nondemented (p < 0,001), 8 sisters who remained nondemented but had memory impairment (p < 0.001), and 24 sisters who were intact with regard to memory and cognition at the final examination prior to death (p = 0.003). In individuals who remained nondemented, hippocampal volume was a better indicator of AD neuropathology than a delayed memory measure. Among nondemented sisters, Braak stages III and VI were distinguishable from Braak stages II or lower (p = 0.001). Among cognitively intact individuals, those in Braak stage II could be distinguished from those in stage I or less (p = 0.025). Conclusion: Volumetric measures of the hippocampus may be useful in identifying nondemented individuals who satisfy neuropathologic criteria for AD as well as pathologic stages of AD that may be present decades before initial clinical expression.