Quantitative MR volumetry in Alzheimer's disease - Topographic markers and the effects of sex and education

被引:99
作者
Kidron, D
Black, SE
Stanchev, P
Buck, B
Szalai, JP
Parker, J
Szekely, C
Bronskill, MJ
机构
[1] Sunnybrook Hlth Sci Ctr, Div Neurol, Cognit Neurol Unit, Res Program Aging, N York, ON M4N 3M5, Canada
[2] Sunnybrook Hlth Sci Ctr, Clin Epidemiol & Hlth Care Res Program, N York, ON M4N 3M5, Canada
[3] Bulgarian Acad Sci, Inst Math & Comp Sci, BG-1040 Sofia, Bulgaria
[4] Chaim Sheba Med Ctr, Tel Aviv, Israel
关键词
D O I
10.1212/WNL.49.6.1504
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We determined topographic selectivity and diagnostic utility of brain atrophy in probable Alzheimer's disease (AD) and correlations with demographic factors such as age, sex, and education. Computerized imaging analysis techniques were applied to MR images in 32 patients with probable AD and 20 age- and sex-matched normal control subjects using tissue segmentation and three-dimensional surface rendering to obtain individualized lobar volumes, corrected for head size by a residualization technique. Group differences emerged in gray and white matter compartments particularly in parietal and temporal lobes. Logistic regression demonstrated that larger parietal and temporal ventricular CSF compartments and smaller temporal gray matter predicted AD group membership with an area under the receiver operating characteristic curve of 0.92. On multiple regression analysis using age, sex, education, duration, and severity of cognitive decline to predict regional atrophy in the AD subjects, sex consistently entered the model for the frontal, temporal, and parietal ventricular compartments. In the parietal region, for example, sex accounted for 27% of the variance in the parietal CSF compartment and years of education accounted for an additional 15%, with women showing less ventricular enlargement and individuals with more years of education showing more ventricular enlargement in this region. Topographic selectivity of atrophic changes can be detected using quantitative volumetry and can differentiate AD from normal aging. Differential effects of sex and years of education can also be detected by these methods. Quantification of tissue volumes in vulnerable regions offers the potential for monitoring longitudinal change in response to treatment.
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页码:1504 / 1512
页数:9
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