摘要
目的:伴有妄想症的痴呆病人的大脑右半球灰质萎缩更加严重,提示一种神经解剖学的定位也许与即将发生的神经变性相关。当这些区域的萎缩减少影响到大脑右半球的正常功能时,痴呆症状与左半球的不对称神经病理也许就会出现。我们假设与相应的无妄想症状伴随的轻度认知障碍(MCI)或阿尔茨海默病早期(AD)相比,伴有妄想症的病人右脑额叶会经历更明显的灰质萎缩。方法:我们采用从阿尔茨海默病的神经影像获得的神经成像和临床数据。在两组年龄、性别、教育和简易精神状态检查量表得分方面相似的基线水平下,采用基于体素的形态学分析方法比较29位无伴有妄想MCI/早期AD参与者与29位伴有妄想的患者。在研究基线上,包括所有的参与者都被诊断患有遗忘型MCI。结果:检测到15例伴有妄想参与者的灰质体素群簇减少。在右脑中央前回、右脑额下回、右脑岛及左侧枕中回观察到明显的灰质减少,这些区域也许参与了控制思考和情感。结论:与相应的无妄想症组病人相比,伴有妄想症的MCI或者早期AD参与者右侧额颞区观察大较大面积的灰质萎缩。与我们预测的一致,大脑右半球不对称灰质萎缩也许有助于损失执行抑制力的妄想症的发展。
关键词: 阿尔茨海默病,妄想,执行控制,抑制,轻度认知障碍,基于体素的形态分析
Current Alzheimer Research
Title:Grey Matter Atrophy in Mild Cognitive Impairment / Early Alzheimer Disease Associated with Delusions: A Voxel-Based Morphometry Study
Volume: 12 Issue: 2
Author(s): Windsor Kwan-Chun Ting, Corinne E. Fischer, Colleen P. Millikin, Zahinoor Ismail, Tiffany W. Chow and Tom A. Schweizer
Affiliation:
关键词: 阿尔茨海默病,妄想,执行控制,抑制,轻度认知障碍,基于体素的形态分析
摘要: Objectives: Grey matter atrophy in the right hemisphere has been shown to be more severe in dementia patients with delusions, suggesting a neuroanatomical localization that may be pertinent to impending neurodegeneration. Delusional symptoms may arise when atrophy in these areas reduces the regulatory functions of the right hemisphere, in tandem with asymmetric neuropathology in the left hemisphere. We hypothesized that delusional patients with either amnestic mild cognitive impairment (MCI) or early Alzheimer Disease (AD) would experience more pronounced grey matter atrophy in the right frontal lobe compared with matched patients without delusions. Methods: We used neuroimaging and clinical data obtained from the Alzheimer’s Disease Neuroimaging Initiative. A comparison group of twenty-nine nondelusional MCI/early AD participants were compared with twenty-nine delusional participants using voxel-based morphometry, matched at baseline by age, sex, education, and Mini-Mental State Exam score. All included participants were diagnosed with amnestic MCI at study baseline. Results: Fifteen voxel clusters of decreased grey matter in participants with delusions were detected. Prominent grey matter decrease was observed in the right precentral gyrus, right inferior frontal gyrus, right insula, and left middle occipital gyrus, areas that may be involved in control of thought and emotions. Conclusion: Greater right fronto-temporal grey matter atrophy was observed in MCI or early AD participants with delusions compared to matched patients without delusions. Consistent with our predictions, asymmetric grey matter atrophy in the right hemisphere may contribute to development of delusions through loss of executive inhibition.
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Windsor Kwan-Chun Ting, Corinne E. Fischer, Colleen P. Millikin, Zahinoor Ismail, Tiffany W. Chow and Tom A. Schweizer , Grey Matter Atrophy in Mild Cognitive Impairment / Early Alzheimer Disease Associated with Delusions: A Voxel-Based Morphometry Study, Current Alzheimer Research 2015; 12 (2) . https://dx.doi.org/10.2174/1567205012666150204130456
DOI https://dx.doi.org/10.2174/1567205012666150204130456 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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