摘要
目的研究阿尔茨海默病(AD)灰质体积改变的性别差异及其与认知损害的相关性。方法纳入AD组患者88例(男37例,女51例),遗忘型轻度认知障碍(aMCI)组患者84例(男40例,女44例)及健康对照(HC)组79例(男34例,女45例),采集高分辨3D T1结构像。采用优化的基于体素形态学测量VBM的方法,使用双因素方差分析得到性别和组别存在交互作用的差异脑区,并把差异脑区作为感兴趣区(ROI),采用REST软件提取灰质体积值,并与简易精神状态检查(MMSE)得分进行相关性分析。结果性别与AD、aMCI及HC组三组组别存在交互作用的脑区包括右侧颞极、右侧眶部额下回、右侧颞中回、双侧前扣带回、右侧中扣带回(P<0.05,团块水平FWE校正),表现为在HC、aMCI组中上述区域的女性灰质体积与男性相仿或略大于男性,而在AD组中女性灰质体积均明显小于男性。相关分析中,将aMCI和AD组合并再按性别分组后,女性患者组MMSE得分与上述5个区域灰质体积均呈正相关(P<0.05),男性患者组MMSE得分与右侧颞中回灰质体积呈正相关(r=0.265,P=0.020);把aMCI和AD两组不合并按性别分组后,女性AD组及男性aMCI组MMSE得分与右侧颞中回灰质体积均呈正相关(r=0.327,P=0.019;r=0.419,P=0.007)。结论AD的进程中脑灰质萎缩存在着性别差异,表现为在局部脑区女性萎缩程度更明显,结构的差异可能会导致认知改变在性别间的不同。
Objective To investigate the differences in gray matter volume(GMV)changes of male and female patients with Alzheimer′s disease(AD)and the potential correlation with cognitive impairment.Methods Eighty-eight patients with AD(37 males and 51 females),84 patients with amnestic mild cognitive impairment(aMCI,40 males and 44 females)and 79 healthy controls(HC,34 males and 45 females)were included.High-resolution 3-dimensional T1 structure images were obtained from each participant.The optimized voxel-based morphological measurement(VBM)method and two-way ANOVA analysis were conducted to investigate differential brain regions with interaction between groups and sexes,which were then chosen as regions of interest(ROI)to extract GMV by the REST software for correlation analysis with the Mini-mental State Examination(MMSE)scores.Results The right temporal pole,right orbital inferior frontal gyrus,right middle temporal gyrus,bilateral anterior cingulate cortex and right middle cingulate cortex were brain regions with interaction between sexes and groups of AD,aMCI and HC(P<0.05,FWE corrected at cluster level).In HC and aMCI groups,the GMV of females in the aforementioned areas was similar to or slightly larger than that of the males,while in the AD group,it bacame significantly smaller than that of males.For correlation analysis,the aMCI and AD patients were combined and then dimidiated into two groups by sex,MMSE scores of the female patient group positively correlated with GMV of the aforementioned five brain regions(P<0.05),MMSE scores of male patient group were positively correlated with GMV of the right middle temporal gyrus(r=0.265,P=0.020).The aMCI and AD patients were separated and then dimidiated into two groups by sex,MMSE scores positively correlated with the GMV from the right middle temporal gyrus in both the female AD group and male aMCI group(r=0.327,P=0.019 and r=0.419,P=0.007).Conclusion There is a difference between the sexes in terms of gray matter atrophy while AD progresses.In particular,some brain
作者
罗时磊
李晓舒
朱婉秋
高子雯
朱佳佳
王海宝
田仰华
周珊珊
余永强
Luo Shilei;Li Xiaoshu;Zhu Wanqiu(Dept of Radiology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)
出处
《安徽医科大学学报》
CAS
北大核心
2021年第10期1650-1655,共6页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81771817、81901726)。
