基于体素的阿尔茨海默病患者脑干形态分析  

A voxel-based morphometry analysis of brainstem in patients with Alzheimer′s disease

作　　者：张鸿 高文朋 何英杰 吉晓曦 李钢[3] 陈晓光[3] Zhang Hong;Gao Wenpeng;He Yingjie;Ji Xiaoxi;Li Gang;Chen Xiaoguang(Graduate School of Guangzhou Medical University,Guangzhou 511436,China;School of Life Science and Technology,Harbin Institute of Technology,Harbin 150080,China;Department of Neurosurgery,the Third People′s Hospital of Hainan Province,Sanya,Hainan 572000,China)

机构地区：[1]广州医科大学研究生院,511436 [2]哈尔滨工业大学生命科学与技术学院,150080 [3]海南省第三人民医院神经外科,三亚572000

出　　处：《中华神经科杂志》2019年第7期525-530,共6页Chinese Journal of Neurology

基　　金：三亚市医疗卫生科技创新项目(2015YW39);三亚市重点实验室项目(L1219).

摘　　要：目的探究阿尔茨海默病(AD)患者脑干的形态学改变及其与海马形态学改变的关系。方法从AD神经影像学计划(ADNI)数据库分别选取60例AD患者(AD组)和60名性别、年龄相匹配的正常老年人(正常对照组)。分割每个受试者的海马和脑干并计算其标准化体积,根据海马体积标准值将AD患者分为两个亚组[海马萎缩组(51例)和海马未萎缩组(9例)。同时采用基于体素的形态学(VBM)研究,以研究正常对照组和AD组以及AD亚组间脑干的形态学差异。结果与正常对照组相比,AD组脑干体积明显减小,差异有统计学意义(分别为16741.31±1739.11、15609.67±1451.60,t=3.870,P=0.001);在AD亚组中,与海马未萎缩组比较,海马萎缩组脑干体积明显减小,差异有统计学意义(分别为16556.30±1514.86、15442.62±1389.05,t=2.189,P=0.033)。Pearson相关分析结果提示AD组简易精神状态检查评分与海马和脑干体积均呈正相关(分别为r=0.590,P<0.01;r=0.234,P<0.05),且海马和脑干体积变化也呈正相关(r=0.315,P=0.014)。VBM结果显示,AD组双侧中脑和双侧脑桥较正常对照组均出现明显萎缩(P<0.05);在AD亚组中,海马萎缩组双侧中脑和左侧脑桥较海马未萎缩组明显萎缩(P<0.05)。结论海马萎缩程度不同的AD患者脑干形态学改变存在差异,海马和脑干形态学改变可能存在相互关系。Objective To investigate the morphological changes of the brainstem in patients with Alzheimer′s disease (AD) and their relationship with hippocampal morphological changes. Methods Sixty AD patients (AD group) and sixty age-and gender-matched normal elderly (normal control group) were selected from the Alzheimer′s Disease Neuroimaging Initiative (ADNI) database. The hippocampus and the brainstem of each subject were segmented and their normalized volumes were calculated. According to the hippocampal volume standard value (Z-score), AD patients were divided into two subgroups (hippocampal atrophy group (n=51) and hippocampal spared group (n=9)). A voxel-based morphology (VBM) study was also performed to investigate the morphological differences of the brainstem between the normal control group and the AD group, as well as between the AD subgroups. Results Compared with the normal control group, the brainstem volume in the AD group decreased significantly (16 741.31±1 739.11 vs 15 609.67±1 451.60, t=3.870, P=0.001). In AD subgroups, the volume of the brainstem in the hippocampal atrophy group was significantly smaller than that in the hippocampal spared group (16 556.30±1 514.86 vs 15 442.62±1 389.05, t=2.189, P=0.033). Pearson correlation analysis showed that Mini-Mental State Examination scores were positively correlated with the hippocampal and the brainstem volumes (r=0.590, P<0.01;r=0.234, P<0.05), and there was a positive correlation between the hippocampal and the brainstem volume changes in patients with AD (r=0.315, P=0.014). VBM results showed that both the bilateral midbrain and the bilateral pons in the AD group had significant atrophy compared with the normal control group (P<0.05). In the AD subgroups, the bilateral midbrain and the left pons in the hippocampal atrophy group were significantly atrophied compared with the hippocampal spared group (P<0.05). Conclusion The brainstem showed morphological changes in patients with AD, and the morphological changes of the brainstem in AD patients wit

关 键 词：关键词阿尔茨海默病 脑干 海马 磁共振成像 基于体素的形态学分析 

分 类 号：R749.16[医药卫生—神经病学与精神病学]