基于体素的形态学用于不同亚型遗忘型轻度认知障碍患者脑灰质改变的研究

Voxel-based morphology for the study of brain gray matter changes in patients with different subtypes of amnestic mild cognitive impairment

目的利用基于体素的形态学分析方法(Voxel based morphometry,VBM)研究不同亚型遗忘型轻度认知障碍(amnesic Mild Cognitive Impairment,aMCI)患者灰质萎缩特点及灰质萎缩与认知功能改变的关系。方法收集2018年8月至2019年8月间牡丹江医学院附属红旗医院记忆门诊存在记忆下降主诉患者36例,完善神经心理学检查后,根据认知受损特点及程度,分为除记忆受损外无其他认知功能损害的单领域aMCI(single domain aMCI,sd-aMCI)18例、以及除了记忆功能损害,还有注意、语言等其它一个或多个认知领域损害的多领域aMCI(multiple domain aMCI,md-aMCI)18例,同时纳入体检正常老年人15例作为对照组(Normal control,NC),采用3.0T磁共振对入组对象进行T1WI扫描,利用DPABI及SPM12软件对扫描获得的结构图像进行预处理,进而对各组全脑灰质体积及灰质改变的结果进行统计学分析。结果与NC相比,sd-aMCI可见双侧扣带回,左侧前额叶存在灰质萎缩改变(P<0.05);md-aMCI可见双侧海马、海马旁回、杏仁核、左颞中回、左侧壳核、左边缘叶、右上顶叶、右楔前叶、楔叶、右侧扣带回以及右侧枕叶中回等存在灰质萎缩(P<0.05)。结论 VBM测量可以显示阿尔茨海默病(Alzheimer’s Disease,AD)早期阶段脑灰质萎缩改变的特点,有助于临床工作中对AD患者的早期诊断。

Objective Voxel based morphometry(VBM)was used to study the characteristics of gray matter atrophy and the relationship between gray matter atrophy and cognitive function changes was analyzed in patients with amnesic mild cognitive impairment(aMCI)of different subtypes.Methods A total of 36 patients with memory loss complaints in the memory clinic of Hongqi Hospital,Mudanjiang Medical College from August 2018 to August 2019 were collected.After the neuropsychological examination was completed,according to the characteristics and degree of cognitive impairment,all the patients was divided into memory impairment 18 cases of single domain aMCI(sd-aMCI)without other cognitive impairments,and multi-domain aMCI(multiple domain,md-aMCI)18 cases with impairment of one or more cognitive domains in addition to memory impairment,attention,language,and 15 normal elderly persons were included as a control group(normal control,NC).The T1WI scan was performed on the enrolled subjects using 3.0T magnetic resonance.The structure obtained by DPABI and SPM12 software.The image was preprocessed,and then the results of the whole brain gray matter volume and gray matter change in each group were statistically analyzed.Results Compared with NC,sd-aMCI showed bilateral buckle gyrus,and there was gray matter atrophy in the left frontal lobe(P<0.05).md-aMCI showed bilateral hippocampus,lateral hippocampus,amygdala,left middle temporal gyrus,and there was gray matter atrophy in the lateral putamen,left marginal lobe,right upper parietal lobe,right anterior wedge lobe,wedge lobe,right cingulate gyrus and right occipital lobe(P<0.05).Conclusion VBM measurement can show the characteristics of altered brain gray matter atrophy in the early stages of Alzheimer’s Disease(AD),which is helpful for the early diagnosis of AD patients in clinical work.