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阿尔茨海默病患者灰质体积变化与认知功能的相关性研究:基于磁共振成像的分析

Investigating the Correlation Between Gray Matter Volume Changes and Cognitive Function Among Alzheimer's Disease Patients: An MRI-Based Analysis.

作者信息

Sun Quan, Ma Luping, Zhao Lulei, Ye Mengfei, Zhu Shaofeng, Zhou Jie

机构信息

Department of Radiology, Shaoxing Seventh People's Hospital, 312000 Shaoxing, Zhejiang, China.

Department of Radiology, Affiliated Hospital of Shaoxing University, 312020 Shaoxing, Zhejiang, China.

出版信息

Actas Esp Psiquiatr. 2025 Aug;53(4):756-765. doi: 10.62641/aep.v53i4.1914.

Abstract

OBJECTIVE

Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive cognitive impairment and memory dysfunction. This study aims to explore changes of gray matter volume and their relationship with cognitive and memory function in AD patients using magnetic resonance imaging-based analysis.

METHODS

This retrospective study analyzed the clinical data from 80 AD patients (AD group) and 45 patients with mild cognitive impairment (MCI group) treated in the hospital between January 2021 and December 2022. Furthermore, 43 healthy adults (control group) were also included for comparison. All the participants underwent a brain magnetic resonance imaging (MRI) examination. These three groups were comparatively analyzed for brain MRI imaging characteristics, changes of gray matter volume, as well as their cognitive and memory functions. Based on gray matter volume, AD patients were divided into the low-volume (37 cases) and high-volume (43 cases) groups using the K-mean clustering method. Furthermore, changes of cognitive and memory function across these two subgroups were compared. The correlation among gray matter volume, cognitive, and memory function across AD patients was assessed using Pearson correlation analysis. Additionally, predictive abilities of gray matter volume in severe cognitive impairment were determined employing receiver operating characteristic (ROC) curve analysis.

RESULTS

The gray matter volume, percentage of gray matter volume, scores of mini-mental state examination (MMSE), and California verbal learning test (CVLT-II) were significantly decreased across the control, MCI, and AD groups (p < 0.05). Compared to the control group, gray matter volume was reduced in the AD and MCI groups. Compared to the high-volume group, gray matter volume, percentage of gray matter volume, scores of MMSE and CVLT-II were decreased in the low-volume group (p < 0.05). Gray matter volume and gray matter volume percentage were positively correlated with scores of MMSE, immediate memory, delayed recall, cue recall, and long-delayed recognition (gray matter volume r = 0.384/0.334/0.308/0.251/0.333; percentage of gray matter volume r = 0.584/0.319/0.299/0.257/0.298; p < 0.001). The area under curve (AUC) for gray matter volume and gray matter volume percentage in predicting severe cognitive impairment were 0.833 (95% CI: 0.747-0.919) and 0.810 (95% CI: 0.715-0.904), respectively (p < 0.001), with sensitivity of 95.24% and 90.48%, and specificity of 66.10% and 67.80%, respectively.

CONCLUSION

MRI is a useful tool for evaluating changes of gray matter volume in AD patients. The changes in gray matter volume are strongly correlated with cognitive and memory functions, which serve as a reliable predictor of severe cognitive impairment in AD patients. Furthermore, MRI provides robust imaging evidence for identifying AD patients at risk of severe cognitive impairment.

摘要

目的

阿尔茨海默病(AD)是一种以进行性认知障碍和记忆功能障碍为特征的神经退行性疾病。本研究旨在利用基于磁共振成像的分析方法,探讨AD患者灰质体积的变化及其与认知和记忆功能的关系。

方法

本回顾性研究分析了2021年1月至2022年12月期间在该医院接受治疗的80例AD患者(AD组)和45例轻度认知障碍患者(MCI组)的临床资料。此外,还纳入了43名健康成年人(对照组)进行比较。所有参与者均接受了脑磁共振成像(MRI)检查。对这三组的脑MRI成像特征、灰质体积变化以及认知和记忆功能进行了比较分析。根据灰质体积,采用K均值聚类法将AD患者分为低体积组(37例)和高体积组(43例)。此外,比较了这两个亚组间认知和记忆功能的变化。采用Pearson相关分析评估AD患者灰质体积、认知和记忆功能之间的相关性。另外,采用受试者工作特征(ROC)曲线分析确定灰质体积对严重认知障碍的预测能力。

结果

对照组、MCI组和AD组的灰质体积、灰质体积百分比、简易精神状态检查表(MMSE)评分和加利福尼亚言语学习测验(CVLT-II)评分均显著降低(p<0.05)。与对照组相比,AD组和MCI组的灰质体积减少。与高体积组相比,低体积组的灰质体积、灰质体积百分比、MMSE评分和CVLT-II评分均降低(p<0.05)。灰质体积和灰质体积百分比与MMSE评分、即时记忆、延迟回忆、线索回忆和长时延迟识别呈正相关(灰质体积r=0.384/0.334/0.308/0.251/0.333;灰质体积百分比r=0.584/0.319/0.299/0.257/0.298;p<0.001)。灰质体积和灰质体积百分比预测严重认知障碍的曲线下面积(AUC)分别为0.833(95%CI:0.747-0.919)和0.810(95%CI:0.715-0.904)(p<0.001),敏感性分别为95.24%和90.48%,特异性分别为66.10%和67.80%。

结论

MRI是评估AD患者灰质体积变化的有用工具。灰质体积变化与认知和记忆功能密切相关,可作为AD患者严重认知障碍的可靠预测指标。此外,MRI为识别有严重认知障碍风险的AD患者提供了有力的影像学证据。

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