遗忘型轻度认知功能障碍患者脑结构的多模态磁共振成像研究  

Multi-modal MRI study of the brain structure in patients with amnestic mild cognitive impairment

作　　者：吴有林[1] 刘芳 余晖 蔡熹 张勇 林雨婵 周腾飞 WU Youlin;LIU Fang;YU Hui(Department of Neurology,Chongzhou People＇s Hospital of Sichuan Province,Chongzhou（611230）,Sichuan,China)

机构地区：[1]四川省崇州市人民医院神经内科,四川崇州611230 [2]贵州医科大学附属医院神经内科 [3]贵州医科大学附属医院影像科

出　　处：《癫痫与神经电生理学杂志》2018年第4期215-222,共8页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨遗忘型轻度认知功能障碍（amnestic Mild Cognitive Impairment，aMCI）患者脑结构损害的特点。方法：对24例aMCI患者及21例健康对照者（Normal controls，NC）完善神经心理学测试，行三维薄层T1加权成像（3D-TIWI）及弥散张量成像（DTI）扫描，应用基于体素的形态学分析（Voxel—Based Morphometry，VBM）方法比较aMCI组与对照组（NC组）灰质体积的差异，使用基于图谱的统计分析（Atlas—Based Analysis，ABA）方法探索aMCI组与NC组主要白质纤维束DTI参数差异区域。结果：①aMCI组患者总体认知功能下降，以延迟回忆、视空间及执行、抽象功能损害最常见；②VBM分析显示aMCI患者大脑灰质萎缩明显，主要的灰质萎缩脑区为双侧颞下回、双侧枕中回、双侧中央后回、右侧额极、右侧额叶内侧眶部、右侧颞极、右侧海马、右侧海马旁回、右侧扣带回前部及中部和左侧运动前区等；③ABA分析提示aMCI患者存在广泛的白质纤维束损害，主要为双侧丘脑前辐射、双侧扣带束扣带回部、双侧皮质脊髓束、左侧扣带束海马部、左侧上纵束和左侧下纵束等。结论：①aMCI患者认知功能损害以延迟记忆、视空间及执行、抽象功能常见；②aMCI患者大脑灰质萎缩广泛，除了累及认知相关灰质脑区，还累及运动及感觉区域灰质，总体以海马及其附近、额叶前部、扣带回灰质萎缩明显；③aMCI患者白质纤维束损害广泛，联络纤维、连合纤维、投射纤维均受累及，其中髓鞘损害范围较轴突损害范围大，大脑前部白质纤维束损害重于后部。Objective：To study the characteristics of brain structure damage in patients with amnestic mild cognitive impairment （aMCI）. Methods： The neuropsychological tests, 3D-TIWI and Diffusion Tensor Imaging（DTI） scans were performed in 24：8 patients with aMCI and 21 healthy subjects（Normal controls）. The voxel-based morphometry（VBM） method was used to assess the differences of gray matter volumes between aMCI patients and Normal controls, the Atlas-Based Analysis（ABA） was used to evaluate the differences between the four DTI parameters of white matter tracts in the two groups. Results： （1） The general cognitive function of the aMCI patients was extensively impaired, with the most common impairment in the delayed recall, visuospatial and executive dcomage, abstraction function dcomage; （2） VBM analysis indicated that aMCI patients had greater gray matter atrophy in the bilateral inferior temporal gyrus, bilateral middle occipital gyrus, bilateral postcentral gyrus and right frontal pole, right medial frontal lobe（orbital）, right temporal pole, right hippocampus, right parahippocampal gyrus, right anterior and middle cingulate gyrus, left premotor area,etc;（3）ABA showed that white matter tracts of aMCI patients were extensively damaged in the bilateral anterior thalamic radiation, bilateral cingulum （cingulate gyrus）, bilateral corticospinat tract, left cingulum（hippocampus）, left superior longitudinal fascicutus, left inferior longitudinal fascieulus, ere, Conclusion： （1） The delayed recall, visuospatial and executive damage, abstraction function damage are the most common in the cognitive impairment of aMCI patients;（2） The aMCI patients have extensive gray matter atrophy, not only involving the regions of cognitive related gray matter., but also the motor and sensory areas. In general,The hippocampus and its surroundings, the frontal lobe, and cingulate gray matter atrophy occur significantly, （3） The white matter tracts injuries in aMCI patients were w

关 键 词：遗忘型轻度认知功能障碍(aMCI) 多模态磁共振成像 体素的形态学分析 脑白质图谱 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]