Exploring the Neural Mechanisms of Mirrored-Self Misidentification in Alzheimer's Disease

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY International Journal of Geriatric Psychiatry Pub Date : 2024-09-27 DOI:10.1002/gps.6148

Zhen Sun, Gang Chen, Jinghuan Gan, Yuqiao Tang, Hao Wu, Zhihong Shi, Tingting Yi, Yaqi Yang, Shuai Liu, Yong Ji

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Abstract

Objective

Alzheimer's disease (AD) is a complex neurodegenerative condition that causes a range of cognitive disturbances, including mirror-self misidentification syndrome (MSM), in which patients cannot recognize themselves in a mirror. However, the mechanism of action of MSM is not precisely known. This study aimed to explore the possible neural mechanisms of action of MSM in AD using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods

This study included 48 AD patients, 13 in the MSM group and 35 in the non-MSM group. The permeability of the blood–brain barrier (BBB) was quantitatively monitored by measuring the transfer rate (K_trans) of the contrast agent from the vasculature to the surrounding tissue using DCE-MRI. The concentration of contrast agents in different brain regions was measured, and the Patlak model was used to calculate K_trans. K_trans values were compared between the left and right cerebral hemispheres in different brain areas between the MSM and non-MSM groups. Additionally, the difference in K_trans values between mild and severe MSM was assessed. Logistic regression analysis was used to examine the risk factors for MSM.

Results

The Mann‒Whitney U test was used to compare two groups and revealed elevated K_trans values in the left thalamus, left putamen, left globus pallidus, left corona radiata, and right caudate in the MSM group (p < 0.05). Logistic regression analysis revealed that increased K_trans values in the left putamen (OR = 1.53, 95% CI = 1.04, 2.26) and left globus pallidus (OR = 1.54, 95% CI = 1.02, 2.31) may be risk factors for MSM. After dividing MSM patients into mild and moderate-severe groups, the K_trans values of the thalamus in the moderate-severe group were greater than those in the mild group (p < 0.05).

Conclusion

Our study revealed the relationship between BBB permeability and MSM in AD. MSM is associated with BBB breakdown in the left putamen and globus pallidus. The left putamen and globus pallidus may function in mirror self-recognition. Higher BBB permeability in the thalamus may reflect the severity of AD in MSM.

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探索阿尔茨海默病镜像自我错认的神经机制

目的：阿尔茨海默病（AD）是一种复杂的神经退行性疾病，会导致一系列认知障碍，包括镜像自我误认综合征（MSM），即患者无法从镜子中认出自己。然而，MSM 的作用机制尚不确切。本研究旨在利用动态对比增强磁共振成像（DCE-MRI）探讨MSM在AD中可能的神经作用机制：本研究共纳入 48 例 AD 患者，其中 13 例为 MSM 组，35 例为非 MSM 组。通过使用 DCE-MRI 测量造影剂从血管到周围组织的转移率（Ktrans），定量监测血脑屏障（BBB）的通透性。测量造影剂在不同脑区的浓度，并使用 Patlak 模型计算 Ktrans。比较了 MSM 组和非 MSM 组左右大脑半球不同脑区的 Ktrans 值。此外，还评估了轻度和重度 MSM 之间 Ktrans 值的差异。采用逻辑回归分析法研究MSM的风险因素：采用 Mann-Whitney U 检验对两组患者进行比较，结果显示，MSM 组患者左丘脑、左侧丘脑、左侧苍白球、左侧放射冠和右侧尾状核的 Ktrans 值升高（左侧丘脑（OR = 1.53，95% CI = 1.04，2.26）和左侧苍白球（OR = 1.54，95% CI = 1.02，2.31）的 p trans 值可能是 MSM 的危险因素。将 MSM 患者分为轻度组和中度重度组后，中度重度组丘脑的 Ktrans 值大于轻度组（P 结语：我们的研究揭示了 BBB 与 MSM 的关系：我们的研究揭示了 AD 中 BBB 通透性与 MSM 之间的关系。MSM与左侧丘脑和球状苍白球的BBB破坏有关。左侧丘脑和球状苍白球可能具有镜像自我识别功能。丘脑中较高的生物BB通透性可能反映出MSM患者AD的严重程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.