基于3D结构核磁分析遗忘型轻度认知功能障碍及阿尔茨海默病患者脑灰质体积的改变及与认知损害的相关性  

The Correlation between Changes in Gray Matter Volume and Cognitive Impairment in Pa⁃tients with Amnestic Mild Cognitive Impairment and Alzheimer’s Disease was Analyzed Based on 3D Structural

作　　者：王俊杰 贾丹丹 桂英 李丽娟 李其富[1] 马琳[1] MRI WANG Junjie;JIA Dandan;GUI Ying;LI Lijuan;LI Qifu;MA Lin(Department of Neurology,First Affiliated Hospital of Hainan Medical College,Haikou 570100,China)

机构地区：[1]海南医学院第一附属医院神经内科,海口570100

出　　处：《神经损伤与功能重建》2024年第8期446-451,461,共7页Neural Injury and Functional Reconstruction

基　　金：海南省自然科学基金-高层次人才项目(CYF IP2基于过表达通过调节自噬-溶酶体通路改善阿尔茨海默病认知功能障碍的作用机制研究,No.821RC1121);海南省自然科学基金青年基金项目(磁共振引导下导航定位高频rTMS对卒中后执行功能障碍的神经调控作用及其脑影像机制研究,No.821QN0987);海南省临床医学中心建设项目(2021)。

摘　　要：目的:探讨遗忘型轻度认知功能障碍(amnestic mild cognitive impairment,aMCI)和阿尔茨海默病(Alzheimer’s disease,AD)患者与正常老年人的灰质体积和皮质厚度差异,分析其与认知水平之间的关系,为临床诊断aMCI及早期AD提供依据。方法:前瞻性纳入a MCI患者23例、AD患者22例及正常对照(Healthy control,HC)组23例。对所有受试者进行脑结构MRI扫描,使用CAT12的Segment功能对3D-T1MRI图像行基于体素的形态学测量和表面形态学测量,获得所有受试者特定脑区的灰质体积及皮质厚度。并运用神经心理学量表进行认知功能评测。分析3组间主要结构灰质体积、皮质厚度的差异,从差异脑区中提取感兴趣区,并探究其与认知量表评分的相关性。结果:3组间方在多个脑区存在差异(FWE校正,P<0.05),差异脑区体积与蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表评分有明显相关性(P<0.05);且不同脑区体积与认知域的相关性大小有明显差异(P<0.05)。结论:a MCI及AD患者脑灰质体积及脑皮质存在不均匀分布的减小。左侧海马、嗅皮质、脑岛的提前萎缩可能是影响AD患者早期认知功能的原因。Objective:To explore the differences in gray matter volume and cortical thickness between patients with amnestic mild cognitive impairment(aMCI)and Alzheimer’s disease(AD)and normal elderly individuals,analyzing their relationship with cognitive level,and providing a basis for clinical diagnosis of aMCI and early AD.Methods:23 aMCI patients,22 AD patients,and 23 healthy control(NC)groups were prospectively included.Structural MRI(sMRI)scans of brain structures were performed on all subjects.The segment function of CAT12 was used to perform voxel based morphology(VBM)and surface based morphology(SBM)measurements on 3D-T1 MRI images,obtaining the gray matter volume and cortical thickness of specific brain regions for all subjects.Cognitive function assessment was conducted using neuropsychological scales.Analyze the differences in main structural gray matter volume and cortical thickness among three groups,extract regions of interest(ROI)from different brain regions,and investigate their correlation with cognitive scale scores.Results:There are differences in multiple brain regions among the three groups(FWE correction,P<0.05),and the volume of different brain regions is significantly correlated with the Montreal Cognitive Assessment(MoCA)scale scores(P<0.05).Moreover,the magnitude of correlation between the volume of different brain regions and cognitive domains varies significantly(P<0.05).Conclusion:There is a reduction in the uneven distribution of gray matter volume and cerebral cortex in patients with aMCI and AD.The early atrophy of the left hippocampus,olfactory cortex,and insula may be a factor affecting early cognitive function in AD patients.

关 键 词：遗忘型轻度认知功能障碍 阿尔茨海默病 磁共振成像 体素形态学测量 表面形态学测量 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学] R742R816