阿尔茨海默病谱系患者的海马亚区体积损害特征

The characteristic of hippocampal subregion volume lesions in patients with Alzheimer’s disease

目的探讨主观认知障碍(subjective cognitive decline,SCD)、遗忘型轻度认知障碍(amnestic mild cognitive impairment,aMCI)及阿尔茨海默病(Alzheimer’s disease,AD)患者海马亚区体积的萎缩模式及与记忆功能障碍的关联。方法收集2016年6月-2019年5月至南京大学医学院附属鼓楼医院神经内科门诊就诊的151例患者。根据认知测试结果和受试者有无记忆下降主诉,分认知正常组43例,SCD组37例,aMCI组35例和AD组36例。FreeSurfer 6.0图像分析软件计算海马12个亚区体积,偏相关分析海马亚区与记忆功能的相关性。结果随着疾病进展,双侧海马总体积、双侧分子层、左侧海马齿状回、左侧CA 4亚区体积显著下降(P均<0.05)。SCD组内海马亚区体积与记忆功能无显著相关(P>0.05),aMCI组内左侧海马尾体积与AVLT-再认评分显著正相关(P<0.05);AD组内双侧下托、前下托,左侧海马裂、旁下托、分子层、齿状回、CA 4、海马杏仁核过渡区、右侧海马伞体积与AVLVT-延时回忆评分相关(P均<0.05)。结论SCD患者已经出现海马总体积和部分海马亚区体积萎缩。AD谱系患者的双侧分子层、左侧海马齿状回、左侧CA 4亚区体积呈显著下降模式,海马亚区体积与记忆功能相关。

Objective To explore the atrophy pattern of hippocampal subregion volume and its correlation with memory function in patients with subjective cognitive impairment(SCD),amnesia mild cognitive impairment(aMCI)and Alzheimer's disease(AD).Methods One hundred and fifty-one participants were recruited from the Neurology clinic,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical from June 2016 to May 2019.According to the cognitive status and whether the subjects had memory impairment complain or not,all participants were divided into normal control group(n=43),SCD group(n=37),aMCI group(n=36)and AD group(n=36).The volumes of 12 subregions were calculated by FreeSurfer 6.0 image analysis software and the correlation between hippocampal subregion and memory function was analyzed by partial correlation analysis.Results As disease progressed,the volume of bilateral molecular layer,left hippocampal dentate gyrus and left CA 4 subregion decreased significantly(all P<0.05).There was no significant correlation between hippocampal subfield volume and memory function in SCD group.A significant positive correlation between left hippocampal tail volume and AVLT-recognition score was observed in aMCI group(P<0.05).Bilateral subiculum,presubiculum volume,left hippocampal fissure,parasubiculum,molecular layer,dentate gyrus,CA 4,hippocampal amygdala transitional area volume and right hippocampal fimbria volume were positively correlated with AVLVT-elayed recall scores(all P<0.05)in AD group.Conclusion The overall volume of hippocampus and some of hippocampal subregion volume had changed as early as SCD stage,and an atrophy pattern of significantly volume decreased in bilateral molecular layer,left dentate gyrus and left CA 4 subregion was discovered.The volume of hippocampal subregion is related to memory.