共查询到10条相似文献,搜索用时 187 毫秒
1.
Barber R McKeith IG Ballard C Gholkar A O'Brien JT 《Dementia and geriatric cognitive disorders》2001,12(3):198-205
OBJECTIVES: To compare medial and lateral temporal lobe atrophy on magnetic resonance imaging (MRI) in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), and to examine the relationship between volumetric indices and cognitive and non-cognitive symptoms. METHODS: T(1)-weighted 1.0-tesla MRI scans were acquired in elderly subjects with DLB (n = 26; mean age = 75.8 years) and AD (n = 22; 77.3 years) and normal controls (n = 26; 76.2 years). MRI-based volume measurements of the hippocampus, parahippocampus, fusiform gyrus, combined inferior and middle temporal gyri, and superior temporal gyrus were acquired. RESULTS: Hippocampal and parahippocampal volumes were significantly larger in subjects with DLB compared to AD. Differences in hippocampal volumes between DLB and AD were observed across the entire length, and in all subjects with dementia there was a loss of hippocampal asymmetry compared to normal controls. Atrophy of temporal lobe structures correlated with memory impairment in both groups, and with age in DLB. There was no association between atrophy and psychotic symptoms in either group. CONCLUSIONS: Subjects with DLB and AD have a different pattern of temporal lobe atrophy with the most striking differences relating to medial rather than lateral temporal lobe structures. These structural differences could explain the relative preservation of memory function in DLB compared to AD. 相似文献
2.
Medial temporal lobe atrophy predicts Alzheimer's disease in patients with minor cognitive impairment 总被引:12,自引:0,他引:12
Visser PJ Verhey FR Hofman PA Scheltens P Jolles J 《Journal of neurology, neurosurgery, and psychiatry》2002,72(4):491-497
OBJECTIVES: To investigate whether medial temporal lobe atrophy predicted outcome in patients with minor cognitive impairment and whether assessment of the medial temporal lobe could increase the predictive accuracy of age and delayed recall for outcome. Quantitative and qualitative methods of assessing the medial temporal lobe were also compared. METHODS: Patients with minor cognitive impairment older than 50 years (n=31) were selected from a memory clinic and were followed up for on average 1.9 years. The medial temporal lobe was assessed in three different ways: volumetry of the hippocampus, volumetry of the parahippocampal gyrus, and qualitative rating of medial temporal lobe atrophy (MTA). Outcome measures were Alzheimer type dementia or cognitive decline at follow up. Delayed recall was tested with a verbal learning test. RESULTS: Ten patients had experienced cognitive decline at follow up, of whom seven had probable Alzheimer type dementia. All medial temporal lobe measurements were associated with cognitive decline at follow up (p trend analysis between 0.001 (hippocampus) and 0.05 (parahippocampal gyrus)). Only the hippocampal volume and MTA score were associated with Alzheimer type dementia at follow up (p trend analysis respectively 0.003 and 0.01). All medial temporal lobe measurements increased the predictive accuracy of age and the delayed recall score for cognitive decline (p increase in predictive accuracy varied between <0.001 (hippocampus) and 0.02 (parahippocampal gyrus and MTA score)) and the hippocampal volume and the MTA score increased the predictive accuracy of age and the delayed recall score for Alzheimer type dementia (p= 0.02). CONCLUSIONS: The ability to detect patients at high risk for Alzheimer type dementia among those with minor cognitive impairment increases when data on age and memory function are combined with measures of medial temporal lobe atrophy. Volumetry of the hippocampus is preferred, but qualitative rating of medial temporal lobe atrophy is a good alternative. 相似文献
3.
Differing patterns of temporal atrophy in Alzheimer's disease and semantic dementia 总被引:15,自引:0,他引:15
Galton CJ Patterson K Graham K Lambon-Ralph MA Williams G Antoun N Sahakian BJ Hodges JR 《Neurology》2001,57(2):216-225
OBJECTIVE: To characterize and quantify the patterns of temporal lobe atrophy in AD vs semantic dementia and to relate the findings to the cognitive profiles. Medial temporal lobe atrophy is well described in AD. In temporal variant frontotemporal dementia (semantic dementia), clinical studies suggest polar and inferolateral temporal atrophy with hippocampal sparing, but quantification is largely lacking. METHODS: A volumetric method for quantifying multiple temporal structures was applied to 26 patients with probable AD, 18 patients with semantic dementia, and 21 matched control subjects. RESULTS: The authors confirmed the expected bilateral hippocampal atrophy in AD relative to controls, with involvement of the amygdala bilaterally and the right parahippocampal gyrus. Contrary to expectations, patients with semantic dementia had asymmetric hippocampal atrophy, more extensive than AD on the left. As predicted, the semantic dementia group showed more severe involvement of the temporal pole bilaterally and the left amygdala, parahippocampal gyrus (including the entorhinal cortex), fusiform gyrus, and the inferior and middle temporal gyri. Performance on semantic association tasks correlated with the size of the left fusiform gyrus, whereas naming appeared to depend upon a wider left temporal network. Episodic memory measures, with the exception of recognition memory for faces, did not correlate with temporal measures. CONCLUSIONS: Hippocampal atrophy is not specific for AD but is also seen in semantic dementia. Distinguishing the patients with semantic dementia was the severe global but asymmetric (left > right) atrophy of the amygdala, temporal pole, and fusiform and inferolateral temporal gyri. These findings have implications for diagnosis and understanding of the cognitive deficits in AD and semantic dementia. 相似文献
4.
Marco Mauri Luisella Sibilla Giorgio Bono Giovanni Augusto Carlesimo E. Sinforiani Adelaide Martelli 《Journal of neurology》1998,245(8):525-530
The aim of the present study was to assess selective atrophy of the temporal lobe and amygdala in the early stages of Alzheimer
dementia (AD). Magnetic resonance imaging (MRI) measurements and the presence of highsignal lesions (HSL) were analysed in
31 patients with mild to moderate probable AD and 22 controls. In the AD group, MRI findings were compared with cognitive
variables and specific features of memory functions. Alzheimer patients showed a significant reduction in volumetric measurement
compared with controls in the total volume (P < 0.01), temporal lobe (P < 0.01) and amygdala (P < 0.05). The temporal lobe/brain volume ratio was also significantly reduced in AD subjects (P < 0.05). Atrophy of temporal structures was significantly related to the degree of episodic and semantic memory impairment
according to a material-specific effect. No significant correlations between amygdala and cognitive variables were found.
The results of our study confirm the usefulness of measures of temporal lobe atrophy assessed with MRI in the diagnosis of
AD. In contrast, HSL are relatively common in AD patients (12/31 cases) and were not related to volumetric findings, severity
of dementia or functional disability.
Received: 11 June 1997 Received in revised form: 6 February 1998 Accepted: 10 February 1998 相似文献
5.
Memory and MRI-based hippocampal volumes in aging and AD 总被引:20,自引:0,他引:20
Petersen RC Jack CR Xu YC Waring SC O'Brien PC Smith GE Ivnik RJ Tangalos EG Boeve BF Kokmen E 《Neurology》2000,54(3):581-587
OBJECTIVE: To demonstrate structural-functional relationships between MRI-based volumetric measurements of medial temporal lobe structures and cognitive function. BACKGROUND: Previous work has documented the ability of MRI-based measurements of the hippocampus to discriminate between age-matched control subjects and patients with very mild AD. Relatively less is known about the correlation between medial temporal lobe structures and cognitive functions. METHOD: We evaluated structural-functional relationships among the hippocampal formation, parahippocampal gyrus, and amygdala, and measures of memory, language, and general cognitive performance in 220 probable AD patients and normal control subjects. Standardized instruments of memory and general cognitive function were used to assess subjects enrolled in a longitudinal study of aging and dementia. RESULTS: The volume of the hippocampal formation predicted performance on most acquisition and recall measures across the spectrum of normal aging and AD. If the groups were segregated, most of the expected associations between medial temporal lobe structures and memory measures were observed in the AD patients. CONCLUSION: MRI-based hippocampal volumetry accurately depicts the structural-functional relationships between memory loss and hippocampal damage across the spectrum from normal aging to dementia. 相似文献
6.
A voxel based morphometry study on mild cognitive impairment 总被引:10,自引:0,他引:10
Pennanen C Testa C Laakso MP Hallikainen M Helkala EL Hänninen T Kivipelto M Könönen M Nissinen A Tervo S Vanhanen M Vanninen R Frisoni GB Soininen H 《Journal of neurology, neurosurgery, and psychiatry》2005,76(1):11-14
BACKGROUND: Mild cognitive impairment (MCI) is the most widely used concept in classifying cognitive impairment in the elderly who do not fulfil the criteria for dementia. MCI is considered to confer an increased risk of progressing to dementia and most often Alzheimer's disease (AD). Various approaches such as imaging of the brain have been applied to predict the conversion of MCI to dementia. A number of volumetric magnetic resonance imaging (MRI) studies have detected atrophy of the medial temporal lobe in subjects with MCI, but for the other cerebral regions the results have been inconsistent. OBJECTIVE: To study the pattern of brain atrophy in MCI. METHODS: Thirty two controls and 51 individuals with MCI deriving from population based cohorts were studied by MRI using voxel based morphometry. The threshold of t maps was set at p < 0.001. RESULTS: Individuals with MCI had significant unilateral atrophy in the medial temporal lobe on the right side. Less extensive atrophy was found elsewhere-for example, in the temporal lobe, left superior parietal lobule, left anterior cingulate gyrus, and bilaterally in the thalami. CONCLUSIONS: The MRI findings in MCI resemble those seen in early AD. 相似文献
7.
Diagnostic accuracy of the Preclinical AD Scale (PAS) in cognitively mildly impaired subjects 总被引:5,自引:0,他引:5
Visser PJ Verhey FR Scheltens P Cruts M Ponds RW Van Broeckhoven CL Jolles J 《Journal of neurology》2002,249(3):312-319
The Preclinical AD Scale (PAS) is a newly developed scale for the diagnosis of preclinical Alzheimer's disease (AD). The
PAS combines six markers of preclinical AD, namely age, MMSE score, functional impairment, cognitive test performance, medial
temporal lobe atrophy, and the apolipoprotein E (APOE) genotype. The aim of the study was to investigate whether the PAS can
accurately identify subjects with preclinical AD who become demented during a 2 or 5 year follow-up from among subjects with
mild cognitive impairment for other reasons. We also investigated whether a step-wise scoring of the PAS could reduce the
number of elaborate or expensive diagnostic procedures. The PAS was scored retrospectively in two independent samples of non-demented
subjects with mild cognitive impairment older than 55 years (average age 65.6 years), who were selected from a memory clinic
population. In the first sample, the follow-up was 5 years (5-year follow-up sample; n=69). In the second sample, the follow-up was 2 years (2-year follow-up sample; n=23). The PAS item medial temporal lobe atrophy was not scored in the 5-year follow-up sample. A PAS cut-off score of 4/5
could best identify subjects with AD-type dementia at follow-up (n=25) in the 5-year follow-up sample with a sensitivity of 80 % and a positive predictive value of 77 %. A PAS cut-off score
of 5/6 could best identify subjects with AD-type dementia at follow-up (n=8) in the 2-year follow-up sample with a sensitivity of 88 % and a positive predictive value of 70 %. The positive predictive
value could be increased to 94 % in the 5-year follow-up sample and to 80 % in the 2-year follow-up sample by using higher
cut-off scores, but this reduced the sensitivity. Step-wise scoring of the PAS had the same diagnostic accuracy as the total
PAS score and reduced the number of cognitive assessments by 22 to 38 %, the number of assessments of medial temporal lobe
atrophy by 57 to 74 %, and the number of APOE genotypings by 74 %. It is concluded that the PAS is a useful scale to identify
subjects with preclinical AD who will become demented during the next 2 or 5 years. Step-wise scoring of the PAS can reduce
the number of elaborate or expensive diagnostic procedures considerably.
Received: 21 February 2001, Received in revised form: 20 July 2001, Accepted: 25 July 2001 相似文献
8.
Medial temporal lobe atrophy in memory disorders 总被引:1,自引:0,他引:1
F. Pasquier Michèle Hamon Florence Lebert Bruno Jacob Jean-Pierre Pruvo Henri Petit 《Journal of neurology》1997,244(3):175-181
Medial temporal lobe atrophy determined by temporal lobe oriented computed tomography (CT), 1 year before death, is strongly
associated with histopathologically confirmed Alzheimer’s disease (AD). The aim of this study was to assess the diagnostic
accuracy of medial temporal lobe measurement for the diagnosis of AD in patients referred to a memory disorders clinic, especially
those at an early stage of the disease. CT oriented to the temporal lobe was performed in 333 subjects aged 41–93 years consecutively
recruited in a Memory Disorders Clinic: 124 had probable AD, Mini Mental State score (MMS) = 17 (8); 50 possible AD [MMS =
21 (5)]; and 119 patients had miscellaneous memory disorders [MMS = 22 (7): frontotemporal lobe dementia, subcortical dementia,
cortical Lewy body disease, vascular dementia, Korsakoff syndrome, focal atrophy, etc.]. There were also 19 anxious/ depressed
patients [MMS = 29 (1)] with normal performance on memory tests, and 21 controls. The minimum width of the medial temporal
lobe was measured. The best cut-off to distinguish AD patients from non-AD patients was 11.5 mm, in agreement with data in
the literature. At this threshold, 84% of probable AD patients had a positive test and 90% of controls and anxious/depressed
patients had a negative test. For the diagnosis of probable AD, sensitivity of the measurement was 0.81, specificity 0.95,
predictive positive value 0.99, predictive negative value 0.45, and diagnostic accuracy 0.83. The test was positive in half
the possible AD patients, and half those with miscellaneous memory disorders. It was negative in all anxious/depressed patients.
Therefore, temporal lobe oriented CT might be a valuable tool for assessment of medial temporal lobe atrophy in AD routine
practice.
Received: 27 September 1995 Accepted: 10 October 1996 相似文献
9.
Teipel SJ Pruessner JC Faltraco F Born C Rocha-Unold M Evans A Möller HJ Hampel H 《Journal of neurology》2006,253(6):794-800
Background Early pathological involvement of specific medial temporal lobe areas is characteristic for Alzheimer’s disease (AD).
Objective To determine the extent of regional medial temporal lobe atrophy, including hippocampus, amygdala, and entorhinal, perirhinal,
and parahippocampal cortices in mild AD patients and healthy controls, and to compare diagnostic accuracy across volumetric
markers.
Methods We studied 34 patients with clinically probable AD and 22 healthy elderly control subjects. Regional volumetric measures were
obtained from volumetric T1–weighted MRI scans after accounting for global brain atrophy using affine transformation into
standard space.
Results Volumes of medial temporal lobe structures were significantly smaller in AD patients than in controls with exception of the
left entorhinal cortex. The degree of atrophy was comparable between all structures. Diagnostic accuracy (number of correctly
allocated cases divided by number of all cases) was highest for the right parahippocampal cortex with 85%, but only slightly
lower for the right hippocampus and right entorhinal cortex with 82% and 84%. Using a linear combination of markers, the unilateral
volumes of the right hippocampus, parahippocampal cortex and perirhinal cortex yielded an accuracy of 93%.
Conclusion Extent of atrophy is similar between the different regions of the medial temporal lobe in mild AD.Volume measurements of medial
temporal lobe structures in addition to the hippocampus only yield improved diagnostic accuracy if a combination of these
structures is used. 相似文献
10.
Pantel J Hüger DR Kratz B Minnemann E Martin M Schad LR Essig M Schröder J 《Der Nervenarzt》2002,73(9):845-850
The aim of the present study was to investigate the morphological changes in subjects with mild cognitive impairment (MCI) revealed by quantitative magnetic resonance imaging (MRI). Twenty-one subjects with cognitive impairment and 22 healthy controls were compared with 12 patients suffering from mild Alzheimer's disease (AD). The volumes of the following brain structures were assessed: total intracranial compartment, cerebrospinal fluid compartment, whole brain, and medial temporal substructures (hippocampus and parahippocampal gyrus). Subjects with mild cognitive impairment showed a significantly reduced volume of the right parahippocampal gyrus over healthy controls. Volumes of the other regions and structures did not differ between the MCI group and controls. The volumetric and neuropsychological findings of the present study support the hypothesis that mild cognitive impairment - at least in some of the affected individuals - can be seen as a preclinical stage of AD and that atrophy of the parahippocampal gyrus might be useful as an early marker of AD. 相似文献