目的 观察阿尔茨海默病(AD)发病进程中海马结构在断层影像上的形态学改变。 方法 依据AD发病进程,分别采集正常对照(NC)组、轻度认知损害(MCI)组、AD组各34例共102例受试者脑核磁共振图像,每组男、女各17例。观测海马面积、横径、矢径和颞叶钩回间距、颞角宽度等。分析组间各测量值变化趋势,以及海马面积等相关测量值与各神经评定量表评分的相关性。 结果 各组海马面积侧别均无统计学差异。各组间测量值比较,AD组海马面积小于NC组及MCI组(P均<0.05);AD组海马横径小于NC组及MCI组,MCI组海马横径小于NC组(P均<0.01);AD组颞叶钩回间距大于NC组及MCI组(P均<0.01),MCI组颞叶钩回间距大于NC组(P<0.05)。海马面积、海马横径与临床痴呆分级量表(CDR)及汉密尔顿抑郁量表(HAMD)评分均呈负相关,与蒙特利尔认知评估量表(MoCA)评分均呈正相关;颞叶钩回间距与神经心理量表评分相关性同海马面积、海马横径相反。 结论 海马面积与海马横径随AD病情进展逐渐缩小,颞叶钩回间距随AD病情进展逐渐增大;海马结构的改变可损伤其认知功能。
Abstract
Objective To observe the morphological changes on sectional imaging of the hippocampal formation (HPF) in patients in the process of alzheimer's disease (AD). Methods According to the pathogenesis of AD, 34 cases of a normal control (NC) group, 34 cases of a mild cognitive impairment (MCI) group, 34 cases of an AD group, which a total of 102 cases were collected, with 17 cases of male and 17 cases of female in each group respectively. The hippocampal area, the transverse diameter, the sagittal diameter and the temporal lobe hook gyrus spacing, the temporal horn width were measured. The change trend of the measured values among the groups and the correlation between the hippocampal area and the scores of the neural rating scale were analyzed. Results There was no statistical difference of hippocampal area in the three groups. Compared with the measured values among the groups, the hippocampal area of the AD group was smaller than that of the NC group and the MCI group (P<0.05).The hippocampal transverse diameter of the AD group was smaller than that of the NC group and the MCI group, and the hippocampal transverse diameter of the MCI group was smaller than that of the NC group (all P<0.01). In AD group, the temporal lobe hook gyrus spacing was greater than that in the NC group and the MCI group (all P<0.01), and in MCI group, the temporal lobe hook gyrus spacing was greater than that in the NC group (P<0.05). Hippocampal area and hippocampal transverse diameter were negatively correlated with clinical dementia scale (CDR) and Hamilton depression scale (HAMD) scores, and positively correlated with Montreal cognitive assessment scale (MoCA) scores;the correlation between the distance of temporal lobe hook gyrus and the score of neuropsychological scale scores was opposite to that of hippocampal area and hippocampal transverse diameter. Conclusions With the progression of AD, the hippocampal area and hippocampal transverse diameter gradually decrease, while the temporal lobe hook gyrus spacing gradually increase. Changes in the hippocampus can damage its cognitive function.
关键词
  /
阿尔茨海默病 /
海马结构 /
MRI
Key words
AD /
Hippocampal formation /
MRI
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参考文献
[1] Sadhu A, Upadhyay P, Agrawal A, et al. Management of cognitive determinants insenile dementia of Alzheimer's type: therapeutic potential of a novel polyherbal drug product[J]. Clin Drug Investig, 2014, 34(12): 857-869.
[2] Galton CJ, Gomez-Anson B, Anroun N, et al. Temporal lobe rating scale: application to Alzheimer's disease and frontotemporal dementia[J]. J Neurol Neurosurg Psychiatry, 2001, 70 (2) :165-173.
[3] Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer′s Association work groups on diagnostic guidelines for Alzheimer's disease[J]. Alzheimers Dement, 2011, 7(3): 280-292.
[4] Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria[J]. Lancet Neurol, 2014, 13 (6): 614-629.
[5] Strasser HC, LilyestromJ, Ashby ER, et al. Hippocampal and ventricular volumes in psychotic and nonpsychotic bipolar patients compared with schizophrenia patients and community control subjects: a pilot study[J]. Biol Psychiatry, 2005, 57 (6): 633-639.
[6] 白桂芹, 刘尚清, 邓世山, 等. 基于人脑海马结构的断层影像学研究[J]. 解剖学杂志, 2015, 38(4): 458-461.
[7] Colla M, Kronenberg G, Deuschle M, et al. Hippocampal volume reduction and HPA-system activity in major depression[J]. J Psychiatr Res, 2007, 41(7): 553-560.
[8] 郭建雄, 江魁明, 张良, 等. 阿尔茨海默病认知功能与海马区MRI表现的相关性[J]. 中国临床康复, 2003, 7(13): 1928-1929.
[9] Frisoni GB, Beltramello A, Weiss C, et al. Linear measures of atrophy in mild Alzheimer disease[J]. AJNR Am J Neuroradiol, 1996, 17(5): 913-923.
[10] 刘智华, 钱学华, 周庭永, 等. 人脑海马结构的形态测量[J]. 中国临床解剖学杂志, 2011, 29(5): 532-535.
[11] Pruessner JC, Li LM, Serles W, et a1.Volumetry of hippocampus and amygdala with high-resolution MRI and three-dimensional analysis software: minimizing the discrepancies between laboratories[J]. Cereb Cortex, 2000, 10(4): 433-442.
[12] 张海军, 刘君. 立体定向健康中国人脑MRI海马结构体积的研究[J]. 中国实用医药, 2009, 4(11): 56-57.
[13] 徐玉玉, 钱学华, 邓玲, 等. MRI分析阿尔茨海默病进程中海马头、体、尾部体积改变[J]. 中国医学影像技术, 2017, 33(6): 853-858.
[14] 赵亮, 王冬青, 朱颖, 等. 阿尔兹海默病患者海马形状、体积变化的影像学特征研究[J]. 中华行为医学与脑科学杂志, 2010, 19(3): 200-202.
[15] Cover KS, van Schijndel RA, Versteeg A, et a1. Reproducibility of hippocampal atrophy rates measured with manual, FreeSurfer, AdaBoost, FSL/FIRST and the MAPS-HBSI methods in Alzheimer's disease[J]. Psychiatry Res Neuroimaging, 2016, 252(30): 26-35.
[16] Mulder ER, de Jong RA, Knol DL, et al. Hippocampal volume change measurement: quantitative assessment of the reproducibility of expert manual outlining and the automated methods Free Surfer and FIRST[J]. Neuro Image, 2014, 92(15), 169-181.
[17] 聂秀玲. 脑部结构磁共振分割算法的研究及其在AD中的应用[D]. 东南大学, 2017.
[18] 孙艺宁. 阿尔茨海默病和轻度认知障碍患者的神经心理学检查和头MRI对照研究[D]. 吉林大学, 2015.
[19] 武文博, 刘任远, 张鑫, 等. 在AD病程中海马代谢水平与体积改变的研究[J]. 东南大学学报(医学版), 2015, 34(4): 489-496.
基金
四川科技厅苗子工程项目(2017054);四川省教育厅项目(16ZB0239);川北医学院教改重点课题(201789)