Improved methods for early diagnosis and non-invasive surrogates of disease severity in Alzheimer's disease (AD) are becoming a modern challenge. Magnetic resonance (MR) techniques are being evaluated as possible surrogate measures of disease progression. The purpose of this work was to correlate the results of combined advanced MRtechniques with neuropsychological performance in order to identify a sensible and sensitive imaging approach to neurodegenerative quantification disease progression. We enrolled 19 patientswith Alzheimer's disease (9 males and 10 females, with a mean age of 74±8). Mean MMSE score of AD patients was 20 ±6. All the AD patients underwent a brain magnetic resonance imaging examinations and a battery of neuropsychological test which included Milan Overoll Dementia Assessment (MODA), Raven's Progressive Matrices, Visual Search, Digit Span, Rey list, prose memory, constructional apraxia, phonological and semantic fluency, and trail making. We measured regional cortical thickness, surfaces and volumes using a set of automated tools (Freesurfer) to reconstruct the brain's cortical surface from T1-weighted three-dimensional volumetric brain magnetic resonance imaging. Magnetic resonance spectroscopy was carried out in the temporal lobes, parietal lobes and frontal lobes; the evaluated metabolites were N-acetylaspartate (NAA),choline (Cho), creatine (Cr). We used Spearman coefficient to analyze the correlation among the different factors. We analyzed the relationship of the regional measure of cortical thickness and volume of vulnerable AD area to severity of symptoms of cognitive impairment. MMSE was directly correlated with the thickness of right brain entorinal cortex, fusiform area, inferior superior and temporal pole (P >0.01). Other significative correlation were observed between left brain vulnerable area and ReyTest and Raven's Progressive Matrices. Sperman’s Rho analisys of MRS ratios NAA/Cr demonstrated an higher significant correlation between the battery of neuropsychological test and right frontal withe matter and left frontal grey matter. Sperman’s Rho analisys of MRS ratios Cho/Cr demonstrated an higher significant correlation between the battery of neuropsychological test and mesial occipital grey matter(Tab.1).We observed a selective correlation between FA measured in corpus callosum (CC) and MMSE, MODA and Rey Test and a preferred correlation between FA evaluated in right fronto-parietal and temporal structures with the major test for cognitive evaluation. Finally with multimodal imaging analysis we observed a combined relationship between FA value of CC, it’s volume and MMSE Combining non conventional magnetic resonance imaging, including morphometry, spectroscopy, MD and FA evaluation, provide a novel framework for both anatomical, metabolic and ultratructural evaluation of neurodegeneration in AD.
Valutazione dei fenomeni neurodegenerativi cerebrali nella Malattia di Alzheimer attraverso metodiche combinate di Risonanza Magnetica Non Convenzionale / Bomboi, Giuseppe. - (2013 Feb 26).
Valutazione dei fenomeni neurodegenerativi cerebrali nella Malattia di Alzheimer attraverso metodiche combinate di Risonanza Magnetica Non Convenzionale
BOMBOI, GIUSEPPE
26/02/2013
Abstract
Improved methods for early diagnosis and non-invasive surrogates of disease severity in Alzheimer's disease (AD) are becoming a modern challenge. Magnetic resonance (MR) techniques are being evaluated as possible surrogate measures of disease progression. The purpose of this work was to correlate the results of combined advanced MRtechniques with neuropsychological performance in order to identify a sensible and sensitive imaging approach to neurodegenerative quantification disease progression. We enrolled 19 patientswith Alzheimer's disease (9 males and 10 females, with a mean age of 74±8). Mean MMSE score of AD patients was 20 ±6. All the AD patients underwent a brain magnetic resonance imaging examinations and a battery of neuropsychological test which included Milan Overoll Dementia Assessment (MODA), Raven's Progressive Matrices, Visual Search, Digit Span, Rey list, prose memory, constructional apraxia, phonological and semantic fluency, and trail making. We measured regional cortical thickness, surfaces and volumes using a set of automated tools (Freesurfer) to reconstruct the brain's cortical surface from T1-weighted three-dimensional volumetric brain magnetic resonance imaging. Magnetic resonance spectroscopy was carried out in the temporal lobes, parietal lobes and frontal lobes; the evaluated metabolites were N-acetylaspartate (NAA),choline (Cho), creatine (Cr). We used Spearman coefficient to analyze the correlation among the different factors. We analyzed the relationship of the regional measure of cortical thickness and volume of vulnerable AD area to severity of symptoms of cognitive impairment. MMSE was directly correlated with the thickness of right brain entorinal cortex, fusiform area, inferior superior and temporal pole (P >0.01). Other significative correlation were observed between left brain vulnerable area and ReyTest and Raven's Progressive Matrices. Sperman’s Rho analisys of MRS ratios NAA/Cr demonstrated an higher significant correlation between the battery of neuropsychological test and right frontal withe matter and left frontal grey matter. Sperman’s Rho analisys of MRS ratios Cho/Cr demonstrated an higher significant correlation between the battery of neuropsychological test and mesial occipital grey matter(Tab.1).We observed a selective correlation between FA measured in corpus callosum (CC) and MMSE, MODA and Rey Test and a preferred correlation between FA evaluated in right fronto-parietal and temporal structures with the major test for cognitive evaluation. Finally with multimodal imaging analysis we observed a combined relationship between FA value of CC, it’s volume and MMSE Combining non conventional magnetic resonance imaging, including morphometry, spectroscopy, MD and FA evaluation, provide a novel framework for both anatomical, metabolic and ultratructural evaluation of neurodegeneration in AD.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
