阿尔茨海默病患者脑体积与认知功能之间的相关性研究  

The correlations between brain volume and cognitive function in patients with Alzheimer′s disease

作　　者：方丹丹 陶慧敏 曹茂红[1] 周宏智[1] 蔡可夫[1] 顾红梅[2] FANG Dandan;TAO Huimin;CAO Maohong;ZHOU Hongzhi;CAI Kefu;GU Hongmei(Department of Neurology,the Affiliated Hospital of Nantong University,Nantong 226001;Department of Imaging,the Affiliated Hospital of Nantong University,Nantong 226001)

机构地区：[1]南通大学附属医院神经内科,南通226001 [2]南通大学附属医院影像科,南通226001

出　　处：《南通大学学报（医学版）》2023年第2期113-117,共5页Journal of Nantong University(Medical sciences)

基　　金：江苏省研究生实践创新计划(SJCX21_1457)。

摘　　要：目的:探讨阿尔茨海默病(Alzheimer′s disease,AD)患者的脑白质体积(white matter volume,WMV)、脑灰质体积(gray matter volume,GMV)、及脑脊液体积(cerebrospinal fluid volume,CSFV)与认知功能之间的相关性,分析其用于AD早期诊断的预测价值。方法:选择2018年9月-2020年9月就诊于南通大学附属医院神经内科门诊及住院诊治的AD患者18例作为AD组,纳入同期在我院进行体检的16例同龄正常人作为正常对照组(NC组)。采用神经功能影像学软件通过矩阵实验室(matrix laboratory,Matlab)使用顺数处理机(calculated by sequence processor,CAT12)计算WMV、GMV。收集入组者年龄、性别、高血压、糖尿病、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、即刻记忆、延迟记忆、连线测试、数字广度实验、波士顿命名等临床资料,分析脑体积与认知功能之间的相关性。通过ROC曲线分析CSFV、WMV、GMV对于AD早期诊断的价值。结果:WMV、GMV与年龄呈负相关,CSFV与年龄呈正相关,AD组及NC组在CSFV、GMV及WMV之间差异有统计学意义(P<0.05)。GMV、WMV、CSFV均与MoCA总评分有关。在MoCA评分分组间不同认知共障碍CSFV、GMV、WMV比较差异有统计学意义,认知功能正常患者GMV及WMV较中重度认知功能障碍患者增加,而CSFV较中重度认知功能障碍患者减少。WMV的AUC为0.96,较CSFV及GMV高。结论:尽管基于体素的形态学分析计算的脑体积尚未纳入诊断AD的生物标志物,但WMV、GMV、CSFV在AD及正常老年人间差异有统计学意义,结合神经心理评估可能有助于早期发现认知障碍和AD。Objective:To explore the correlation between white matter volume,gray matter volume,and cerebrospinal fluid volume and cognitive function in Alzheimer′s disease(AD)patients,and to explore its predictive value for early diagnosis of AD.Methods:Eighteen AD patients who visited the outpatient and inpatient Department of Neurology of Nantong University Affiliated Hospital from September 2018 to September 2020 were selected as the AD group,and 16 normal patients of the same age who underwent physical examination in our hospital during the same period were included as the normal control group(NC group).WMV and GMV volume of AD group and NC group were calculated by sequence processor(CAT12)using matrix laboratory(Matlab).Clinical data including age,gender,hypertension,diabetes,MoCA score,immediate memory,delayed memory,wired test,digit breadth experiment and Boston naming were collected to analyze the correlation between brain volume and cognitive function.The value of CSFV,WMV,and GMV for the early diagnosis of AD was analyzed by the ROC curve.Results:WMV and GMV were negatively correlated with age,CSFV was positively correlated with age,and there were significant differences between CSFV,GMV,and WMV in the AD and NC groups(P<0.05).GMV,WMV,and CSFV were all related to the total Montreal cognitive assessment(MoCA)score.Different cognitive co-impairment CSFV,GMV,and WMV increased GMV and WMV in patients with moderate to severe cognitive impairment,while CSFV decreased in patients with moderate to severe cognitive impairment.The AUC of WMV is 0.96,which is higher than the CSFV and GMV.Conclusion:Although brain volumes calculated from voxel-based morphological analysis have not yet included biomarkers for diagnoses of AD,while WMV,GMV,and CSFV combined with neuropsychological assessment may be helpful for early detection of cognitive impairment and AD.

关 键 词：阿尔茨海默病 顺数处理机 基于体素的形态学分析 认知障碍 灰质体积 白质体积 

分 类 号：R749.16[医药卫生—神经病学与精神病学]