摘要
目的用磁共振扩散张量成像(DTI)研究阿尔茨海默病(AD)患者脑白质损害的特点及其与认知功能改变的相关性。方法对16例AD患者和12名年龄及性别相当的健康老年人行DTI、T1液体衰减反转恢复序列(FLAIR)及T2-FLAIR检查,测量胼胝体膝部和压部、内囊前肢和后肢、额颞顶枕叶白质的部分各向异性分数值(FA)和平均弥散度(MD),分析FA、MD值与简易精神状态量表(MMSE)评分之间的相关关系。结果AD患者胼胝体压部、额叶、顶叶、颞叶FA值分别为0.602±0.043、0.270±0.034、0.294±0.043、0.302±0.032,与健康老人组相比显著下降(P<0.05),且与MMSE评分呈正相关关系,而内囊前后肢、枕叶、胼胝体膝部的FA值则无明显变化(P>0.05);胼胝体压部、顶叶白质的MD值分别为(0.918±0.029)、(0.826±0.015)×10-9m2/s,与健康老人组相比显著升高(P<0.01),且与MMSE评分呈负相关,而内囊前后肢、额叶、颞叶、枕叶和胼胝体膝部的MD值则无明显变化(P>0.05)。结论AD患者表现为脑白质的选择性损害,且损害程度与认知功能密切相关;这种选择性损害反映了AD病理机制中皮质-皮质及皮质-皮质下联系的丢失;DTI技术可以用来监测疾病的进展情况及评价AD治疗药物的临床疗效。
Objective To investigate the nature of white matter damage and its correlation to the cognition function in patients with Alzheimer＇s disease （AD） by using the diffusion tensor imaging （DTI）. Methods Diffusion tensor imaging, as well as T1-fluid attenuated inversion recovery（FLAIR） and T2-FLAIR, was performed in probable AD patients and sex and age matched healthy volunteers to measure the fractional anisotropy （FA） and mean diffusivity （MD） in the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule and the white matter of the frontal, temperal, parietal and occipital lobes. Correlation analysis was applied to reveal the relationship between the FA and MD values and the MMSE scores. Results In contrast to healthy controls, patients with AD have a lower FA in the splenium of corpus callosum （0.602±0.043 ）, as well as in the white matter of the frontal （0.270±0.034 ）, temperal （0.302±0.032）, and parietal lobes （0.294±0.043）. Besides, FA of AD Patients was also strongly positive correlated with MMSE scores, but there was no difference in FA between AD Patients and controls in the anterior and posterior limbs of internal capsule, occipital lobes white matter and the genu of corpus callosum. While in comparison with that of healthy controls, MD of AD Patients was significantly higher in the splenium of corpus callosum （（0.918±0.029）×10^-9 m^2/s） and parietal lobes white matter （（0.826±0.015）×10^-9 m^2/s） and was strongly negative correlated with MMSE scores, but there was no difference in MD between AD patients and controls in the anterior and posterior limbs of internal capsule, as well as in frontal, temporal, occipital lobes white matter and the genu of corpus callosum. Conclusion The white matter of patients with AD should be selectively impaired and the extent of damage should have a strong correlation with the cognition function. The selective impairment might reflect the cortico-cortical and cortico-subcorti
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2006年第2期76-79,共4页
Chinese Journal of Neurology
基金
国家自然科学基金资助项目(30400512)
广东省自然科学基金资助项目(20013137)
广东省社会发展项目(2005B10401047)
广州市科技计划资助项目(2004Z3-E0151)
关键词
阿尔茨海默病
认知障碍
磁共振成像
弥散
Alzheimer disease
Cognition disorders
Diffusion magnetic resonance imaging
