阿尔茨海默病神经血管耦合障碍的影像学进展  

Progress in imaging research of neurovascular coupling disorders in Alzheimer's disease

作　　者：李婷 戚荣丰 张冰[1] Li Ting;Qi Rongfeng;Zhang Bing(Department of Radiology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Institute of Medical Imaging and Artificial Intelligence,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,南京大学医学影像与人工智能研究所,南京210008

出　　处：《中华行为医学与脑科学杂志》2024年第11期1007-1012,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(82330059,82271965);江苏省自然科学基金(BK20221554);科技创新2030—"脑科学与类脑研究"重大项目(2022ZD0211800);南京鼓楼医院引进人才科研启动基金(RC2024-055)。

摘　　要：阿尔茨海默病(Alzheimer's disease,AD)是一种进行性的神经退行性疾病,深入研究其发病机制以实现疾病早期诊断以及确定潜在的治疗靶点是当前的研究重点。脑血管功能障碍被认为是AD的一个重要的病理生理机制,神经血管耦合作为神经活动与血管反应的桥梁,成为AD脑血管功能障碍的研究新前沿,为揭示血管病理学和AD病理学之间的关联性提供了新的视角。本文通过梳理归纳已有研究,基于多种影像学技术在神经血管耦合中的应用,探讨AD连续谱系的大脑血流灌注和神经电活动的变化。结果发现,在多种影像技术中均能观察到AD脑血流灌注的代偿机制,并且大脑血流灌注和神经电活动的减少与认知功能的恶化相关。基于多模态影像学得到的神经血管耦合指标,在区分健康人以及不同认知障碍程度患者时表现出良好的敏感性和特异性,有望成为评估AD的有效影像生物标志物。Alzheimer's disease(AD)is a progressive neurodegenerative disease,and in-depth study of its pathogenesis to enable early diagnosis of the disease,as well as identification of potential therapeutic targets,are the current research priority.Cerebrovascular dysfunction is considered to be an important pathophysiological mechanism in AD.Neurovascular coupling,which serves as a bridge between neural activity and vascular response,has emerged as a new frontier in the study of cerebrovascular dysfunction in AD.It provides a new perspective to reveal the correlation between vascular pathology and AD.This article reviewd and summarized existing research on changes in cerebral blood perfusion and neural electrical activity across the AD continuum,using various imaging techniques to assess neurovascular coupling.The results indicate that compensatory mechanisms in cerebral blood perfusion can be observed in AD using multiple imaging techniques,and reductions in cerebral blood perfusion and neural electrical activity correlate with the deterioration of cognitive function.Neurovascular coupling indicators derived from multimodal imaging demonstrate good sensitivity and specificity in distinguishing healthy individuals from patients with varying degrees of cognitive impairment,holding promise as effective imaging biomarkers for assessing AD.

关 键 词：阿尔茨海默病 神经血管耦合 脑功能成像 脑血流量 动脉自旋标记 

分 类 号：R749.16[医药卫生—神经病学与精神病学]