DTI评价轻度认知障碍及轻中度阿尔茨海默病脑白质微细结构损害的研究  

Study of microstructural white matter lesions in patients with mild cognitive impairment and mild and moderate Alzheimer disease

作　　者：王建华[1] 吕佩源[1,2] 王贺波[2] 李志立[2] 黄越[3] 李娜[2] 孙占用[2] 赵宝华[2] 

机构地区：[1]河北医科大学神经病学教研室,050051 [2]河北省人民医院神经内科,050051 [3]澳大利亚威尔士王子医学研究所,新南威尔士大学

出　　处：《中国神经免疫学和神经病学杂志》2010年第3期211-214,共4页Chinese Journal of Neuroimmunology and Neurology

基　　金：河北省自然科学基金资助项目(C2009001483)

摘　　要：目的应用磁共振弥散张量成像(DTI)技术研究轻度认知障碍(MCI)及轻中度阿尔茨海默病(AD)患者脑白质微细结构的改变。方法对MCI患者、轻中度AD患者各12例及健康老年人12名(对照组)行常规MRI及DTI检查,测量其胼胝体压部、额叶、顶叶、颞叶、枕叶、内囊前肢及内囊后肢白质区部分各向异性分数(FA)和平均弥散率(MD)。将3组的FA、MD值进行比较,并与MMSE评分、单词回忆及单词再认评分进行相关性分析。结果 (1)MCI患者顶叶白质FA值为0.489±0.079,与对照组(0.558±0.079)相比下降(P<0.05)。(2)AD患者额叶、顶叶及颞叶FA值分别为0.405±0.072、0.454±0.069和0.363±0.056,与对照组(分别为0.499±0.081、0.558±0.079和0.440±0.061)比较差异均有统计学意义(P<0.05)。AD患者胼胝体压部、额叶及顶叶MD值分别为0.978±0.082、0.920±0.054和0.81 7±0.045,均高于对照组(分别为0.801±0.093、0.820±0.084、0.712±0.096)(P<0.05)。AD、MCI两组内囊前、后肢及枕叶FA及MD值分别与健康对照组比较均无统计学差异(P>0.05)。(3)3组顶叶、颞叶FA值与MMSE、单词回忆及单词再认评分均有相关性(分别r=0.869、-0.621、-0.759,均P<0.01;r=0.446、-0.486、-0.361,均P<0.05),胼胝体压部FA值与单词再认评分有相关性(r=-0.343,P<0.05);3组胼胝体压部及顶叶MD值与MMSE、单词回忆及单词再认评分均有相关性(分别r=-0.612、0.547、0.586,均P<0.01;r=-0.576、0.499、0.519,均P<0.01),内囊前肢MD值与MMSE评分相关(r=-0.340,P<0.05)。结论 MCI及轻中度AD患者存在脑白质选择性微细结构损害,且该损害出现在与高级皮层功能相关的脑区,而与初级功能相关的区域未见明显受损。Objective To investigate the microstructural white matter lesions in patients with mild cognitive impairment （MCI） and mild and moderate Alzheimer disease （AD） by using diffusion tensor imaging （DTI） technique. Methods 12 patients with MCI, 12 patients with mild and moderate AD, and 12 normal controls （NC） were recruited. DTI images were acquired, and fractional anisotropy （FA）, mean diffusivity （MD） of normal-appearing white matter （NAWM） in the splenium of the corpus callosum, frontal, parietal, temporal, occipital lobes, and anterior and posterior limbs of the internal capsule were determined. These diffusion measurements were compared across the 3 groups, and significant differences were further performed for correlation with scores of MMSE, word recall and word recognition. Results （1） Compared with NC group, MCI patients were demonstrated decreased FA value in the parietal lobe （0. 558±0. 079 and 0. 489±0. 079 respectively, P〈0.05）. （2） FA values in NC group were 0. 499±0. 081, 0.558±0.079 and0.440±0.061, and in AD patients were 0. 405±0. 072, 0. 454±0. 069 and 0. 363±0. 056 respectively in the frontal, parietal and temporal NAWM. FA values decreased significantly in AD patients （P〈0.05）. MD values in the NC group were 0.801±0.093, 0.820±0.084 and 0.712±0.096, and in AD patients were 0.978±0.082, 0.920±0.054 and 0. 817±0. 045 in the splenium of the corpus callosum, frontal and parietal NAWM, respectively. Compared with NC, MD values were significantly increased in AD patients （P^O. 05）. No significant differences were found in the anterior and posterior limbs of the internal capsule and the occipital NAWM between AD patients and NC group （P〉0.05）. （3） FA values in parietal and temporal lobes were significantly correlated with the scores of MMSE, word recall and word recognition （P〈0.05）, and FA value in the splenium of the corpus callosum NAWM was significantly correlated with word recognition （P〈0.05）. MD values in the

关 键 词：轻度认知障碍 阿尔茨海默病 磁共振波谱学 

分 类 号：R749.15[医药卫生—神经病学与精神病学]