Microstructural Alteration of the Anterior Cingulum is Associated With Apathy in Alzheimer Disease
Microstructural Alteration of the Anterior Cingulum is Associated With Apathy in Alzheimer Disease
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DOI：
10.1097/jgp.0b013e31820dcc73
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发表时间：
2011-07-01
影响因子：
7.2
通讯作者：
Woo, Jong Inn
中科院分区：
文献类型：
--
作者：
Kim, Jee Wook;Lee, Dong Young;Woo, Jong Inn
目的：确定阿尔茨海默病（AD）患者与情感淡漠相关的白色完整性区域改变。设计：横断面研究。地点：University Dementia Clinic参与者：51名极轻度或轻度疑似AD受试者。干预：容积磁共振成像与扩散张量成像。测量值：进行感兴趣体积分析，以比较冷漠组和无冷漠组之间的局部各向异性分数（FA），并检验局部FA与冷漠严重程度之间的线性关系。冷漠通过神经精神量表进行评估。结果如下：冷漠组在左前扣带回（A-C）中的FA值显著低于无冷漠组，无论是否伴随抑郁和精神药物。左侧A-C FA值也有显着的线性关系与冷漠的综合评分作为衡量冷漠的严重程度，即使在控制同侧前扣带皮层的灰质密度。结论：我们的研究结果支持前扣带皮层和其他脑结构之间通过A-C的通信故障有助于AD冷漠的发展和加重，另外支持AD临床表现为断开综合征的一般概念。(Am J Geriatr Psychiatry 2011; 19：644-653）
Objectives: To identify regional alterations of white matter integrity associated with apathy in Alzheimer disease (AD). Design: Cross-sectional study. Setting: University Dementia Clinic. Participants: Fifty-one very mild or mild probable AD subjects. Intervention: Volumetric magnetic resonance imaging with diffusion tensor imaging. Measurements: Volume of interest analyses were performed to compare regional fractional anisotropy (FA) between apathy and apathy-free group, and to test linear relationship between regional FA and apathy severity. Apathy was assessed by the Neuropsychiatric Inventory. Results: Apathy group showed significantly lower FA values than apathy-free group in the left anterior cingulum (A-C), regardless of concomitant depression and psychotropic medications. Left A-C FA values also had significant linear relationship with apathy-composite scores as a measure of apathy severity, even after controlling gray matter density of the ipsilateral anterior cingulate cortex. Conclusions: Our findings support that communication failure between the anterior cingulate cortex and other brain structures via the A-C contributes to the development and aggravation of apathy in AD, additionally supporting the general notion of disconnection syndrome for clinical manifestation of AD. (Am J Geriatr Psychiatry 2011; 19:644-653)