阿尔茨海默病脑功能磁共振功能成像研究进展

doi:10.3969/j.issn.2095-1396.2017.03.002

摘要/Abstract

摘要： 阿尔茨海默病（Alzheimer's disease，AD）是一种常见于老年人的神经退行性疾病，其主要影响患者的认知功能、精神行为及日常交往能力。结构影像学技术主要用于测量大脑结构，为AD 的诊断提供支持，但早期AD 患者结构影像学并无特征性改变，其协助诊断的敏感性和特异性均不高，而脑功能成像检查可以弥补这些不足，同时也可探索AD 的病理生理机制。该文综述了血氧水平依赖性功能磁共振成像（blood oxygen level dependence functional magnetic resonance imaging，BOLD-fMRI）、弥散成像（diffusion-weighted imaging，DWI）、弥散张量成像（diffusion tensor imaging，DTI）、磁共振波谱（magnetic resonance spectroscopy，MRS）及静息态功能磁共振（resting state functional magnetic resonance imaging，RS-fMRI）等目前常用于AD 脑研究的功能影像学方法。

关键词: 阿尔茨海默病, 磁共振成像, 结构影像学, 功能影像学

Abstract: Alzheimer’s disease （AD） is a commom neurodegenerative disorder in the elderly， which mainly manifeste cognitive function， behavioral and psychological symptoms，and activities of daily living. Structue imaging technology is mainly used for measuring the brain structure， which provides support for the diagnosis of AD， but structural imaging of early stage Alzheimer’s disease has no characteristic changes， and it has low sensitivity and specificity for AD diagnosis. However， functional magnetic resonance imaging （fMRI） of brain can compensate for structural imaging technology， and explore the mechanism of pathophysiological of AD. In this paper， we reviewed the functional imaging methods for studying AD nowdays， such as， blood oxygen level dependent functional magnetic resonance imaging （BOLD-fMRI）and diffusion-weighted imaging （DWI）， diffusion tensor imaging （DTI）， magnetic resonance spectroscopy（ MRS） and resting state fMRI（ RS-fMRI）， and so on.

Key words: Alzheimer&rsquo, s disease（AD）, magnetic resonance imaging, structural imaging, functional imaging

中图分类号:

R964

白彦昌，贾艳丽，宋亚雪，王建华. 阿尔茨海默病脑功能磁共振功能成像研究进展[J]. 神经药理学报, 2017, 7(3): 6-11.

BAI Yan-chang，JIA Yan-li，SONG Ya-xue，WANG Jian-hua. Advance of Functional Magnetic Resonance Imaging of Brain in Alzheimer’s Disease[J]. Acta Neuropharmacologica, 2017, 7(3): 6-11.

参考文献

[1] Tgeodore P Zanto, Judy Pa, Adam Gazzaley. Reliability measures of functional magnetic resonance imaging in a longitudinal evaluation of mild cognitive impairment [J]. Neuroimage, 2014, 84: 443-452.

[2] Hampstead B M, Mohammad Khoshnoodi, Yan Wen-jing, et al. Patterns of effective connectivity during memory encoding and retrieval differ between patients with mild cognitive impairment and healthy older adults [J]. Neuroimage, 2016, 124(Pt A): 997-1008

[3] Li Chuan-ming, Zheng Jian, Wang Jian, et al. An fMRI stroop task study of prefrontal cortical function in normal aging, mild cognitive impairment, and Alzheimer's disease [J].Curr Alzheimer Res, 2009, 6(6): 525-530.

[4] Christppher A Hostage, Kingshuk Roy Choudhury, P Murali Doraiswamy, et al. Mapping the effect of the apolipoprotein E genotype on 4-year atrophy rates in an Alzheimer disease-related brain network [J]. Radiology, 2014, 271(1): 211-219.

[5] Albert C Yang, Chu-Chung Huang, Liu Mu-En, et al. The APOE ?4 allele affects complexity and functional connectivity of resting brain activity in healthy adults [J]. Hum Brain Mapp, 2014, 35(7): 3238-3248.

[6] 唐梅丽, 陈鑫, 陈志远, 等. 肌萎缩侧索硬化症在3.0TMR及弥散张量纤维束示踪技术上的表现 [J].暨南大学学报: 自然科学与医学版, 2014, 35(6):555-560.

[7] Ana Filipa Geraldo, Lise-Prune Berner, Julie Haesebaert, et al. Does b1000-b0 mismatch challenge diffusion-weighted imaging-fluid attenuated inversion recovery mismatch in stroke? [J]. Stroke, 2016, 47(3):877-881.

[8] Michaela Defrancesco, Egger Karl, Josef Marksteiner, et al. Changes in white matter integrity before conversion from mild cognitive impairment to Alzheimer's disease[J]. PLoS One 2014, 9(8):e106062.

[9] Zhang Yu, Nobert Schuff, Monica Camacho, et al. MRI markers for mild cognitive impairment: comparisons between white matter integrity and gray matter volume measurements [J]. PLoS One, 2013, (6):e66367.

[10] Lerner A, Mogensen M A, Kim P E, et al. Clinical applications of diffusion tensor imaging [J]. World Neurosurg, 2014, 82(1-2):96-109

[11] Wang Jian-hua, Lv Pei-yuan, Wang He-bo, et al. Diffusion tensor imaging measures of normal appearing white matter in patients who are aging, or have amnestic mild cognitive impairment, or Alzheimer's disease [J]. J ClinNeurosci, 2013, 20(8):1089-1094.

[12] Yawu Liu, Gabriela Spulber, Kimmo K Lehtimäki, et al. Diffusion tensor imaging and tract-based spatial statistics in Alzheimer's disease and mild cognitive impairment [J]. Neurobiol Aging, 2011, 32(9): 1558-1571.

[13] Olivier Naggara, Catherine Oppenheim, Dorothee Rieu, et al. Diffusion tensor imaging in early Alzheimer's disease [J]. Psychiatry Res, 2006, 146(3): 243-249.

[14] Po H Lu, Grace J Lee, Jill Shapira, et al. Regional differences in white matter breakdown between frontotemporal dementia and early-onset Alzheimer's disease[J]. J Alzheimers Dis, 2014, 39(2):261-269

[15] Min-Chien Tu, Chung-Ping Lo, Ching-Feng Huang, et al. Effectiveness of diffusion tensor imaging in differentiating early-stage subcortical ischemic vascular disease, Alzheimer's disease and normal ageing [J]. PLoS One, 2017, 12(4):e0175143.

[16] Kejal Kantarci. Fractional anisotropy of the fornix and hippocampal atrophy in Alzheimer's disease [J]. Front Aging Neurosci, 2014, 13(6):316.

[17] Milap A Nowrangi, Constantine G Lyketsos, Jeannie-Marie S Leoutsakos, et al. Longitudinal, region-specific course of diffusion tensor imaging measures in mild cognitive impairment and Alzheimer's disease[J]. Alzheimers Dement, 2013, 9(5):519-528.

[18] Heidi IL Jacobs, Martin P J van Boxtel, Ed H B M Gronenschild, et al. Decreased gray matter diffusivity: a potential early Alzheimer's disease biomarker? [J]. Alzheimers Dement, 2013, 9(1):93-97.

[19] 李香春, 刘江红, 王海平, 等. 弥散张量成像对遗忘型轻度认知障碍诊断和预后评估的价值 [J]. 中国全科医学, 2016, 19(11): 1282-1286.

[20] 陈旭高, 邹建勋, 王明杰, 等. 3.0T磁共振ASL及MRS技术在阿尔茨海默病的应用研究 [J]. 医学影像学杂志, 2015, 25(1):14-17.

[21] Maja A A Binnewijzend, Joost P A Kuijer, Marije Benedictus, et al. Cerebral blood flow measured with 3D pseudocontinuous arterial spin-labeling MR imaging in Alzheimer disease and mild cognitive impairment: a marker for disease severity [J]. Radiology, 2013, 267(1):221-230.

[22] Simonsen C Z, Madsen M H, Schmitz M L, et al. Sensitivity of diffusion- and perfusion-weighted imaging for diagnosing acute ischemic stroke is 97.5% [J]. Stroke, 2015, 46(1): 98-101.

[23] Aikaterini Xekardaki, Cristelle Rodriguez, Marie-Louise Montandon, et al. Arterial spin labeling may contribute to the prediction of cognitive deterioration in healthy elderly individuals [J]. Radiology, 2015, 274(2):490-499.

[24] Zou Jian-Xun, Wang Ming-Jie, Lei Xin-Jun, et al. 3.0 T MRI arterial spin labeling and magnetic resonance spectroscopy technology in the application of Alzheimer's disease [J]. ExpGerontol, 2014, 60:31-36.

[25] Zhang Bing, Tanis J Ferman, Bradley F Boeve, et al. MRS in mild cognitive impairment: early differentiation of dementia with Lewy bodies and Alzheimer's disease [J]. J Neuroimaging, 2015, 25(2):269-274

[26] Huang Dan-dan, Liu Dan, Yin Jian-zhong, et al. Erratum to: Glutamate-glutamine and GABA in brain of normal aged and patients with cognitive impairment [J]. EurRadiol, 2017, 27(7):2706-2707.

[27] Fayed N, Modrego P J, García-Martí G, et al. Magnetic resonance spectroscopy and brain volumetry in mild cognitive impairment. A prospective study [J]. MagnReson Imaging, 2017, 38:27-32.

[28] Wang Hui, Tan Lan, Wang Hui-Fu, et al. Magnetic Resonance Spectroscopy in Alzheimer's Disease: Systematic Review and Meta-Analysis [J]. J Alzheimers Dis, 2015, 46(4):1049-1070.

[29] Wolfgang Grodd, Beckmann C F. Resting state functional MRI of the brain [J]. Nervenarzt, 2014, 85(6): 690-700.

[30] Stavros Dimitriadis. Quantifying the predictive power of resting-state functional connectivity (rs-fc) fMRI for identifying patients with Alzheimer's disease (AD) [J]. ClinNeurophysiol, 2015, 126(11): 2043-2044.

[31] Edward Challis, Peter Hurley, Laura Serra, et al. Gaussian process classification of Alzheimer's disease and mild cognitive impairment from resting-state fMRI [J]. Neuroimage, 2015, 15(112):232-243.

[32] Stefan J Teipel, Alexandra Wohlert, Coraline Metzger, et al. Multicenter stability of resting state fMRI in the detection of Alzheimer's disease and amnestic MCI [J]. Neuroimage Clin, 2017, 18(14):183-194.

[33] Wang Yu-mei, Zhao Xiao-chuan, Xu Shun-jiang, et al. Using regional homogeneity to reveal altered spontaneous activity in patients with mild cognitive impairment [J]. Biomed Res Int, 2015, 2015:807093.

[34] Bin-ke Yuan, Wang Jue, Zang Yu-feng, et al．Amplitude differences in high-frequency fMRI signals between eyes open and eyes closed resting states [J]. Front Hum Neurosci, 2014, 8:503.

[35] Han Ying, Wang Jin-hui, Zhao Zhi-lian, et al. Frequency-dependent changes in the amplitude of low-frequency fluctuations in amnestic mild cognitive impairment: a resting-state fMRI study [J]. Neuroimage, 2011, 55(1):287-295．

[36] 周波, 张增强, 安宁豫, 等. 轻度认知障碍患者丘脑功能连接的随访研究[J]. 临床和实验医学杂志, 2014,13(10): 784-788.

[37] 姚洪祥, 安宁豫, 张熙, 等. 遗忘型轻度认知障碍杏仁核功能连接静息态纵向变化功能磁共振研究 [J]. 放射学实践, 2014, 29, (6); 613-617．

[38] 盛灿, 夏明睿, 陈晓丹, 等. 遗忘型轻度认知障碍患者的静息态功能连接强度特征研究 [J]. 中华放射学杂志, 2016, 50(3): 191-195.

[39] 席芊, 赵小虎, 王培军, 等．遗忘型轻度认知损害患者基于低频振幅的静息态功能磁共振成像研究 [J]. 上海交通大学学报, 2014, 34(8):1162-1166.

[40] Wang Yan, Chen Ke-wei, Yao Li, et al. Structural interactions within the default mode network identified by Bayesian network analysis in Alzheimer's disease [J]. PLoS One, 2013, 8(8):e74070.