Regional rates of neocortical atrophy from normal aging to early Alzheimer disease
Regional rates of neocortical atrophy from normal aging to early Alzheimer disease
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DOI：
10.1212/wnl.0b013e3181b16431
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发表时间：
2009-08-11
期刊：
影响因子：
9.9
通讯作者：
Dale, A. M.
中科院分区：
文献类型：
--
作者：
McDonald, C. R.;McEvoy, L. K.;Dale, A. M.
目的：探讨从正常年龄到早期阿尔茨海默病(AD)新皮质萎缩的空间模式和区域比率。方法：采用高通量图像分析技术对472例正常、轻度认知损害(MCI)或AD患者的纵向MRI数据进行分析。根据临床痴呆评定盒总分(CDR-SB)将受试者分为4组。通过计算基线扫描和12个月扫描之间皮质体积丢失的百分比来计算年萎缩率。使用重复测量协方差分析来评估作为损伤函数的跨区域萎缩率的组差异。结果：在MCI-CDR-SB 0.5-1的患者中，每年的萎缩率最大的是内侧、中下外侧、顶下和后扣带回。随着损伤程度的增加(MCI-CDR-SB 1.5-2.5)，萎缩扩展到顶叶、额叶和枕叶外侧皮质，然后是前扣带回皮质。对区域轨迹的分析显示，所有临床受损的新皮质区域的萎缩率都在增加。然而，内侧颞叶皮质的萎缩率在早期疾病中增加得更多，而在额叶、顶叶、后颞叶、顶叶和扣带回皮质的萎缩率在晚期增加得更多。结论：萎缩在不同区域之间并不均匀，也不遵循线性轨迹。了解从正常衰老到阿尔茨海默病的空间模式和下降速度，可以为发现早期疾病和监测疾病进展不同阶段的治疗效果提供有价值的信息。神经病学(R)2009；73：457-465
Objective: To evaluate the spatial pattern and regional rates of neocortical atrophy from normal aging to early Alzheimer disease (AD).Methods: Longitudinal MRI data were analyzed using high-throughput image analysis procedures for 472 individuals diagnosed as normal, mild cognitive impairment (MCI), or AD. Participants were divided into 4 groups based on Clinical Dementia Rating Sum of Boxes score (CDR-SB). Annual atrophy rates were derived by calculating percent cortical volume loss between baseline and 12-month scans. Repeated-measures analyses of covariance were used to evaluate group differences in atrophy rates across regions as a function of impairment. Planned comparisons were used to evaluate the change in atrophy rates across levels of disease severity.Results: In patients with MCI-CDR-SB 0.5-1, annual atrophy rates were greatest in medial temporal, middle and inferior lateral temporal, inferior parietal, and posterior cingulate. With increased impairment (MCI-CDR-SB 1.5-2.5), atrophy spread to parietal, frontal, and lateral occipital cortex, followed by anterior cingulate cortex. Analysis of regional trajectories revealed increasing rates of atrophy across all neocortical regions with clinical impairment. However, increases in atrophy rates were greater in early disease within medial temporal cortex, whereas increases in atrophy rates were greater at later stages in prefrontal, parietal, posterior temporal, parietal, and cingulate cortex.Conclusions: Atrophy is not uniform across regions, nor does it follow a linear trajectory. Knowledge of the spatial pattern and rate of decline across the spectrum from normal aging to Alzheimer disease can provide valuable information for detecting early disease and monitoring treatment effects at different stages of disease progression. Neurology(R) 2009; 73: 457-465