| 唐 银,张 玲,丁洪园,朱 奕,王 彤,高雅新,祁 鸣.基于前康复理念下的阿尔茨海默病临床前期患者的脑自发活动探索性研究[J].中国康复医学杂志,2022,(4):458~464 |
| 基于前康复理念下的阿尔茨海默病临床前期患者的脑自发活动探索性研究 点此下载全文 |
| 唐 银 张 玲 丁洪园 朱 奕 王 彤 高雅新 祁 鸣 |
| 南京医科大学第一附属医院放射科，江苏省南京市，21002 |
| 基金项目：国家自然科学基金青年科学基金项目（81802244）；国家重点研发计划（2018YFC2001600，2018YFC2001603）；国家自然科学基金面上项目（81971237）；南京市科技计划（2019060002） |
| DOI：10.3969/j.issn.1001-1242.2022.04.004 |
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| 摘要： |
| 摘要
目的：探讨低频振幅（amplitude of low-frequency fluctuation， ALFF）在阿尔茨海默病（Alzheimer's disease， AD）临床前期即主观认知下降（subjective cognitive decline， SCD）患者中的变化及其与临床认知评估量表的相关性，从功能影像角度帮助识别存在进展到AD风险的患者，为开展前康复延缓其认知的衰退提供依据。
方法：本研究共纳入27例主观认知下降患者，25例轻度认知障碍患者（mild cognitive impairment， MCI），26例健康对照组（healthy control， HC），各组间性别、年龄以及受教育年限相匹配。所有受试者均行静息态功能磁共振成像扫描，采用ALFF分析方法，比较静息状态下三组间ALFF值存在差异的脑区；利用Pearson相关分析对存在显著差异脑区的ALFF值与临床认知评估量表进行相关性分析。
结果：与HC组相比，MCI组与SCD组ALFF值在右侧缘上回以及左侧楔前叶明显减低，SCD组ALFF值在右侧辅助运动区显著减低，SCD组与MCI组差异不明显（GRF correction，voxel P<0.001， cluster P<0.05）。所有被试简易智能状态检查量表评分与左侧楔前叶（r=0.231，P=0.042）及右侧辅助运动区（r=0.263，P=0.02）呈正相关。所有被试蒙特利尔认知评估量表评分与右侧缘上回（r=0.365，P=0.001）、左侧楔前叶（r=0.370，P=0.001）及右侧辅助运动区（r=0.264，P=0.02）呈正相关。连线测试A评分（r=﹣0.327，P=0.004）及连线测试B评分（r=﹣0.375，P=0.001）分别与左侧楔前叶呈负相关；波士顿命名与左侧楔前叶（r=0.364，P=0.001）呈正相关；符号数字模式测试与左侧楔前叶（r=0.382，P=0.001）呈正相关。
结论：患者处于AD临床前期时ALFF值即有明显改变，并与临床认知评估量表存在一定的相关性，基于静息态功能磁共振的研究有利于对SCD患者作出早期诊断，并为AD前康复提供依据。 |
| 关键词：主观认知下降 轻度认知障碍 前康复 功能磁共振成像 低频振幅 |
| Aberrant spontaneous brain activity of patients in preclinical stages of Alzheimer's disease based on prehabilitation： a resting-state fMRI study Download Fulltext |
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| Department of Radiology， The First Affiliated Hospital of Nanjing Medical University， Jiangsu， Nanjing， 210029 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To investigate the changes in amplitude of low-frequency fluctuation (ALFF) and the correlations between ALFF and clinical cognitive evaluations in subjective cognitive decline (SCD) patients， supply some help for the diagnosis of patients who may develop into Alzheimer's disease (AD) from the perspective of functional magnetic resonance imaging and provide foundation for prehabilitation to prevent cognitive decline in these patients.
Method： We recruited 27 clinically confirmed SCD patients and 25 mild cognitive impairment (MCI) patients in this study. 26 healthy controls (HCs) were also included for comparison. Their gender， age and years of education were matched. All resting-state functional magnetic resonance (rs-fMRI) experiments were performed for each subject. To compare the changes of resting brain area among these three groups in the resting state， we use the ALFF analysis method. In addition， Pearson correlation analyses were employed to evaluate the relationships between ALFF values and clinical scores of all subjects.
Result： Compared with HC group， both MCI and SCD groups showed lower ALFF values at the right supramarginal gyrus and left precuneus region. Lower ALFF values at right supplementary motor area were also found in SCD group when compared with HC group. There was no significant difference between SCD and MCI patients（GRF correction， voxel P value<0.001， cluster P value<0.05）. The mini mental status examination (MMSE) was positively correlated with the ALFF values of left precuneus (r=0.231， P=0.042) and right supplementary motor area (r=0.263， P=0.02) in all subjects. The Montreal cognitive assessment (MoCA) was positively correlated with the ALFF values of right supramarginal gyrus (r=0.365， P=0.001)，left precuneus (r=0.370， P=0.001) and right supplementary motor area (r=0.264， P=0.02) in all subjects. The trail making test-A (TMT-A)(r=﹣0.327， P=0.004) and TMT-B (r=﹣0.375，P=0.001) scores were negatively correlated with the ALFF values at left precuneus. Meanwhile， a significant positive correlation was found between the ALFF values at left precuneus (r=0.364， P=0.001) and Boston-Naming-Test. Symbol digit modalities test was positively correlated with the ALFF values at left precuneus (r=0.382， P=0.001).
Conclusion： The ALFF values of patients in preclinical stages of AD was significantly changed， and they were strongly correlated with multiple clinical scores. The research based on resting-state functional magnetic resonance (rs-fMRI) is conducive to the early diagnosis of patients with subjective cognitive decline， and provides evidence for the prehabilitation of patients in preclinical stages of AD. |
| Keywords:subjective cognitive decline mild cognitive impairment prehabilitation functional magnetic resonance imaging amplitude of low-frequency fluctuation |
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