目的利用优化的基于体素的形态学研究方法,比较遗忘型轻度认知损害(aMCI)和轻度阿尔茨海默病(AD)患者脑灰质体积。方法选取aMCI患者9例(aMCI组)、轻度AD患者13例(AD组)和正常老年志愿者7例(对照组),经T2加权像排除颅内存在白质高密度信号,对其进行高分辨率三维T1加权像扫描,数据在参数统计软件包SPM5下进行头颅标准化、优化、分割和平滑等处理。结果aMCI组的双侧颞上回、额中回、中央前回、扣带回、顶下小叶、左侧颞中回、中央后回、海马旁回、右侧岛回和旁中央小叶等结构灰质体积小于对照组,差异有统计学意义(P〈0.01)。aMCI组的双侧颞上回、齿状回、额上回、额中回、岛回、左侧楔前叶、中央后回、右侧颞中回、颞下回、额下回、顶上小叶和海马旁回等结构灰质体积大于AD组,差异有统计学意义(P〈0.01)。结论基于体素的形态学研究能够发现aMCI患者颞、顶、额叶均存在一定程度萎缩,其萎缩程度与累及范围均介于正常老人与轻度AD之间。
Objective To compare the volumes of gray matter (GM) with optimized voxel-based morphometry(VBM) between individuals with amnestic mild cognitive impairment(aMCI) and patients with mild Alzheimer's disease(AD). Methods Nine subjects with aMCI(aMCI group), 13 patients with mild AD(AD group),and 7 healthy elderly(control group) with normal-appearance of white matter were enrolled in this study. High-resolution 3D TI MR images were acquired. All 3D T1 images were analyzed with SPM5 software by following the procedures of coregistration, modulation, segmentation, and smoothing. Results Compared with control group, there was significant GM volumetric reduction in bilateral superior temporal gyri,middle frontal gyrus, precentral gyrus, cingulate gyrus, inferior parietal lobule, left middle temporal gyrus, postcentral gyrus, parahippocampal gyrus, right insula and paracentral lobule in aMCI group (P〈0.01). In aMCI group, GM volumes of bilateral superior temporal gyri, dentate gyrus, superior frontal gyrus, middle frontal gyrus, insula, left precuneus lobe, postcentral gyrus, right middle temporal gyrus,inferior temporal gyrus, inferior frontal gyrus, superior parietal lobule, and parahippocampal gyrus were significantly larger than those in AD group (P〈0.01). Conclusion VBM analysis suggests significant regional atrophy in temporal, frontal and parietal regions in aMCI patients. The cerebral atrophy in aMCI is more severe and spread than normal elderly, and less severe and spread than mild AD.