基于ADNI数据的海马结构亚区体积及Tau病变与认知损伤的相关性研究  

Association of the volume and tau pathology of sub-fields of hippocampal formationwith cognitive declinebased on ADNI data

作　　者：盖新亭 吴琛 徐凯 GE Xin-ting;WU Chen;XU Kai(School of Medical Imaging,Xuzhou Medical University,Jiangsu 221004,China)

机构地区：[1]徐州医科大学医学影像学院,江苏221002 [2]徐州医科大学附属医院影像科

出　　处：《放射学实践》2020年第12期1493-1498,共6页Radiologic Practice

基　　金：国家自然科学基金青年基金(81801776);江苏省自然科学基金青年基金(BK20170256);徐州市科技局项目(KC17164)。

摘　　要：目的:探讨不同β-淀粉样蛋白(Aβ)状态下,阿尔茨海默症患者海马结构各亚区体积及tau蛋白病变程度与认知功能损伤之间的相关性。方法:从阿尔茨海默症神经成像数据库(ADNI)中筛选出143例样本。其中,认知功能正常(CN)87例,轻度认知障碍(MCI)46例,轻度阿尔茨海默症(AD)10例。所有被试行tau-PET、amyloid-PET、MR T1WI和T2WI扫描,并采集其认知量表得分(ADAS_cog)。利用自动化海马结构亚区分割(ASHS)软件计算各亚区的体积,利用FreeSurfer软件,计算不同亚区的tau蛋白病变程度,观察海马结构亚区体积和tau蛋白病变程度在不同Aβ状态下的差异,并分析其与认知量表得分之间的相关性。结果:与Aβ正常组相比,Aβ异常组的年龄更大(t=-2.3692,P=0.0192),携带载脂蛋白E(APOE)等位ε4基因者更多(t=21.31,P=2.4e-05),认知损伤更严重(t=-3.5583,P=5.11e-4),但两组被试的受教育程度和性别分布无明显差异(P>0.05)。两组的tau蛋白病变程度的差异有统计学意义,表现为Aβ异常组的tau蛋白病变在下托(左侧:t=-2.9419,P=0.0054,右侧:t=-3.1079,P=0.0033)、内嗅皮层(左侧:t=-3.8987,P=2.98e-4,右侧:t=-3.8369,P=3.75e-4)、海马旁回(左侧:t=-3.5367,P=9.15e-4,右侧:t=-4.0475,P=2.83e-4)等区域更严重,而两组的体积差异仅表现在左侧CA1区域(t=3.2951,P=0.0124)。对于Aβ正常组,左、右两侧海马结构均表现为认知损伤与内嗅皮层的tau蛋白病变相关(左侧:r=0.2775,P=0.0499,右侧:r=0.2891,P=0.0362),而体积变化则与认知损伤无相关性。对于Aβ异常组,体积变化与认知损伤表现出一定程度的相关性(左侧Brodmann36区:r=-0.3343,P=0.0355;右侧海马旁回:r=-0.3317,P=0.0479),而tau蛋白病变与认知损伤的相关区域进一步增多(左侧CA1:r=0.3939,P=0.0252;右侧海马旁回:r=0.5121,P=0.0009)。结论:在AD疾病进程中,tau蛋白病变的出现可能早于体积的变化。tau蛋白病变并未表现出半球差异,而体积变化则有明显的半�Objective:The purpose of this study was todelineate the correlation between tauopathy/volume and cognitive decline for different sub-fields of the hippocampal formation under different amyloidβ-protein(Aβ)status.Methods:143 subjects were selected from Alzheimer's Disease Neuroi-maging Initiative(ADNI)project,including 87 cases in cognitive normal(CN),46 cases in mild cognitive impairment(MCI),and 10 cases in mild Alzheimer′s disease.All subjects underwent tau-PET,amyloid-PET,and MR T1WI and T2WI scan.Cognitive decline was assessed by Alzheimer's Disease Assessment Scale-Cognitive(ADAS_cog).The sub-fields of the hippocampal formation were segmented automatically using Automatic Segmentation of Hippocampal Subfields(ASHS)software,and volumes of these sub-fields were calculated.The tau pathology was calculated using FreeSurfer software,referenced by the grey matter of cerebellum.The relationships between tau pathology or changes of sub-field volume and clinical assessment scores were finally analyzed.Results:Compared with amyloid negative group,individuals from amyloid positive group were older in age(t=-2.3692,P=0.0192),with more carriers of APOEε4(t=21.31,P=2.4e-05),and more severe in cognitive decline(t=-3.5583,P=5.11e-04).However,no significant difference in education level and gender distribution were found between the two groups.Severer tau pathology with amyloid positive group was mainly in the subiculum(left:t=-2.9419,P=0.0054,right:t=-3.1079,P=0.0033),the entorhinal cortex(left:t=-3.8987,P=2.98e-04,right:t=-3.8369,P=3.75e-04),and para-hippocampus(left:t=-3.5367,P=9.15e-04;right:t=-4.0475,P=2.83e-04)for both left and right hippocampi,while volume difference was only with CA1 region of left hippocampal formation(t=3.2951,P=0.0124).For amyloid negative group,tau pathology was correlated with cognitive decline mainly in the entorhinal cortex on both left and right CA(left:r=0.2775,P=0.0499;right:r=0.2891,P=0.0362).No correlations were found between volume and cognitive decline for amyloid negative group.Fo

关 键 词：阿尔茨海默症 认知 海马 淀粉样蛋白 TAU蛋白 正电子发射体层摄影术 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.6[医药卫生—诊断学]