阿尔茨海默病患者精神行为症状与海马及其亚区灰质体积关系的研究

目的 研究阿尔茨海默病（AD）患者的精神行为症状（NPS）与海马及其亚区灰质体积的相关性。方法 选择2017年1月至2018年12月就诊于安徽医科大学第一附属医院记忆障碍门诊的20例AD患者作为AD组，同期选择体检中心及门诊的20例健康者作为对照组。所有被试者均进行成套神经心理学评估，采集其结构核磁共振数据。基于感兴趣区水平，探索NPS与海马及其亚区灰质体积的相关性。结果 AD组患者汉密尔顿焦虑量表、汉密尔顿抑郁量表及神经精神问卷的评分均高于对照组，差异有统计学意义（P<0.05）。AD组患者双侧海马及左海马情感、认知和感知亚区灰质体积较对照组下降，差异均有统计学意义（P<0.05）。AD患者的汉密尔顿抑郁量表评分与左海马认知亚区（r=0.456，P=0.043）和感知亚区（r=0.537，P=0.014）的灰质体积呈正相关。结论 AD患者中存在明显的精神行为症状，左海马感知及认知亚区灰质体积异常可能是AD发生精神行为症状神经机制中的关键环节。

A study of neuropsychiatric syndrome in Alzheimer's disease and its relationship with gray matter volume of hippocampus and hippocampus sub-region

Objective To explore the neuropsychiatric symptoms(NPS) in patients with Alzheimer''s disease(AD) and the correlation between NPS in AD and the gray matter volume(GMV) of hippocampus and hippocampus sub-region. Methods From Jan 2017 to Dec 2018, 20 AD patients and 20 healthy controls were included in the study. All subjects completed a set of neuropsychological assessments, and their structural magnetic resonance imaging data were collected. Based on the level of the region of interest, the correlation between NPS and the hippocampus and its sub-regions were explored. Results AD had remarkably higher scores of Hamilton anxiety scale, Hamilton depression scale(HAMD),and neuropsychiatric questionnaire thanthose of health control with statistical difference(P<0.05).The GMV of bilateral hippocampus and the left hippocampus sub-region of AD were significantly lower than those of health control (P<0.05). HAMD scores of AD were positively related to GMV of the left hippocampal cognitive region(r=0.456,P=0.043) and the perceived region(r=0.537, P=0.014). Conclusions NPS is obvious in AD patients, and the GMV abnormalities of perception and cognitive sub-region of left hippocampus may be the key link in the neurological mechanism of NPS in AD.