阿尔茨海默病高风险人群的结构和静息态功能MRI特征  

Structural and resting-state functional MRI characteristics of patients at high risk for Alzheimer＇s disease

作　　者：胡忠婕[1] 盛灿 孙宇[1] 张忠敏[1] 张伟[1] 李瑜霞[1] 李红艳[1] 孙建平[1] 秦海滨[1] 李坤成[2] 贾建平[1] 韩璎[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]首都医科大学宣武医院放射科,北京100053

出　　处：《中华神经科杂志》2014年第12期824-830,共7页Chinese Journal of Neurology

基　　金：国家自然科学基金资助项目（81261120571,30970823,31371007）;神经内科国家临床重点专科建设项目;国家重点基础研究发展计划（973） （2010CB732600）;国家科技支撑计划（2012BAI10B00）;首都市民健康培育项目（Z131100006813022）

摘　　要：目的 探讨遗忘型轻度认知障碍（aMCI）患者的结构MRI （sMRI）和静息态功能MRI（rs-fMRI）特点;并初步探索短期内进展为阿尔茨海默病（AD）的aMCI患者的sMRI和rs-fMRI特征.方法 采用方差分析比较32例aMCI患者及与之相匹配的28名健康对照者和22例AD患者的基线期神经心理学量表得分、全脑灰质体积和后扣带回种子点的静息态功能连接（RSFC）差异.采用t检验比较经过随访（1～5年）确定的13例aMCI进展AD者（aMCI-P）和19例未进展AD者（aMCI-S）上述3个指标的组间差异.结果 （1） aMCI组灰质体积减小在数值上介于健康对照组和AD组之间,主要位于双侧海马和海马旁回、双侧丘脑以及双侧扣带回和楔前叶等脑区;与AD组比较,aMCI组被试双侧海马旁回、双侧尾状核头以及右侧岛叶和右侧角回灰质体积改变较小;与aMCI-S组比较,aMCI-P组患者颞叶萎缩更加明显.（2） aMCI患者肺部与后扣带回之间的RSFC下降比健康对照组多,比AD组患者少,主要脑区位于右侧角回和楔前叶;与aMCI-S组比较,aMCI-P组患者右侧角回与后扣带回之间的RSFC下降更加明显.结论 海马旁回体积改变、右侧角回与后扣带回之间的RSFC改变可以作为aMCI患者早期诊断和转化预测的潜在sMRI和rs-fMRI影像学标志.Objective To investigate the imaging characteristics of amnestic mild cognitive impairment （aMCI） patients using structural MRI （sMRI） and resting-state functional MRI （rs-fMRI）,particularly structural and functional differences between the aMCI patients who progressed to probable Alzheimer＇ s disease （aMCI-P） within a relatively short period and others who remained stable （aMCI-S）.Methods Thirty-two aMCI patients and 28 age-matched normal control （NC） underwent baseline and 1-5 years follow up sMRI scans.Thirteen of the 32 aMCI patients were in the aMCI-P group and others in aMCI-S group.The baseline sMRI and rs-fMRI data of NC and aMCI patients together with data of 22 Alzheimer＇s disease （AD） patients were used,and image preprocessings were carried out using SPM 8,voxel-based morphometry and data parocessing assistant for rs-fMRI.Analysis of variance was performed to analyze the neuropsychological tests scores,gray matter （GM） volume and posterior cingulate cortex （PCC）resting-state functional connectivity （RSFC） changes among the three groups.Two-sample t test was processed to compare the neuropsychological tests scores,GM volume and PCC RSFC differences between the aMCI-P and aMCI-S groups.Results The value of GM volume loss in aMCI patients was between NC and AD patients,and the main regions were in the bilateral hippocampi and parahippocampal gyri,bilateral thalami,cingulate cortices and precuneus.Compared with AD patients,aMCI group showed less GM volume loss in bilateral parahippocampal gyri,heads of caudate nucleus,right insula and angular gyrus.While compared with aMCI-S group,aMCI-P patients performed severer GM atrophy in the bilateral temporal lobes.The aMCI patients showed a greater PCC RSFC decline than NC but less than AD,and the main regions were in the right angular gyrus and precuneus.Compared with aMCI-S group,aMCI-P patients showed decreased RSFC in the right angular gyrus.Conclusion These preliminary findings may provide structural and resting-sta

关 键 词：阿尔茨海默病 轻度认知障碍 磁共振成像 

分 类 号：R749.16[医药卫生—神经病学与精神病学]