Vertex-wise shape analysis of subcortical structures in Alzheimerʼs disease

B. Bagepally, J. John, P. Sivakumar, S. Bharath, S. Jain, M. Varghese
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Abstract

Background: Most MRI studies in Alzheimer’s disease (AD) have focused on cortical and hippocampal atrophy. This study, however, examines regional volumetric and shape abnormalities of subcortical and limbic structures in AD. Methods: Thirty-six patients with AD and 36 matched controls were included in the study. All subjects were right-handed, evaluated using standard clinical assessment scales and genotyped at ApoE locus. Structural T1- weighted images were acquired using 3 Tesla MRI. Vertex-wise shape analysis was performed, with age, gender and total brain volume used as covariates of no interest. Data on the volumes of the hippocampus, amygdala, caudate, putamen and thalamus were statistically analyzed. Results: The bilateral hippocampus, amygdala, caudate, putamen and thalamus of AD patients were significantly lower in volume than controls. With respect to ApoE4 carrier status, there were no within-group volumetric differences in either AD or controls. Vertex-wise shape analysis of AD patients revealed significant surface reductions at the bilateral hippocampus, amygdala, caudate and putamen. No shape-wise difference was observed between ApoE4 carrier and non-carrier subjects in either group. Correlation analysis revealed a significant negative correlation between the Hindi mental status examination score, and shape analysis of atrophy of the hippocampus, caudate and putamen. Conclusions: Significant volume reductions and shape differences were observed in subcortical and limbic structures in AD patients. The observed atrophy of neocortical and deep grey matter structures in AD patients indicates ongoing degenerative processes in the amygdala, caudate and putamen – similar to the hippocampus – which may contribute to cognitive and/or other clinical features in AD.
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阿尔茨海默病皮质下结构的顶点形状分析
背景:大多数阿尔茨海默病(AD)的MRI研究都集中在皮质和海马萎缩。然而,这项研究检查了阿尔茨海默病皮质下和边缘结构的区域体积和形状异常。方法:选取36例AD患者和36例对照组。所有受试者均为右撇子,使用标准临床评估量表进行评估,并在ApoE位点进行基因分型。使用3特斯拉MRI获得结构T1加权图像。进行顶点形状分析,年龄、性别和总脑容量作为无兴趣的协变量。对海马、杏仁核、尾状核、壳核和丘脑的体积数据进行统计学分析。结果:AD患者双侧海马、杏仁核、尾状核、壳核和丘脑体积明显低于对照组。关于ApoE4携带者状态,AD和对照组的组内体积均无差异。AD患者的顶点形状分析显示,双侧海马、杏仁核、尾状核和壳核的表面明显减少。两组ApoE4携带者与非携带者之间均无形体差异。相关分析显示,印地语精神状态考试得分与海马、尾状核和壳核萎缩形态分析呈显著负相关。结论:阿尔茨海默病患者的皮质下和边缘结构体积明显减小,形状明显不同。阿尔茨海默病患者新皮质和深部灰质结构的萎缩表明,杏仁核、尾状核和壳核正在发生退行性过程——类似于海马体——这可能有助于阿尔茨海默病患者的认知和/或其他临床特征。
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