杂志文章%A Kamagata Koji %A Christina Andica %A Takabayashi Kaito %A Saito Yuya %A Taoka Toshiaki %A Nozaki Hayato %A菊田纯子%A萩原昭惠%A神谷Kouhei %A和田明彦%A赤石明宏%A西泽光雄%A堀正明%A长川慎司%A青木茂木%A关于阿尔茨海默氏病神经影像学研究%T轻度认知障碍中Glymphatic系统MRI指标与淀粉样蛋白沉积和认知的相关性阿尔茨海默病%D 2022 %R 10.1212/WNL。背景与目的glymphatic系统是一个首页全脑血管周围网络，促进脑脊液/间质液交换。该系统的改变可能在淀粉样蛋白β (a β)的积累中起关键作用。然而，其在阿尔茨海默病(AD)发病机制中的作用尚不完全清楚。在这里，我们研究了轻度认知障碍(MCI)和AD患者与血管周围网络相关的无创MRI测量的变化。此外，我们还探讨了MRI测量与神经心理评分、PET标准化摄取值比(SUVR)和Aβ沉积的关系。方法比较来自阿尔茨海默病神经成像计划数据库的MCI患者、AD患者和健康对照的MRI测量指标，包括血管周围空间(PVS)体积分数(PVSVF)、白质游离水体积分数(fww - wm)和沿血管周围空间扩散指数(ALPS指数)。在MCI和AD患者的联合亚队列中，MRI测量也与CSF生物标志物、PET SUVR和认知评分水平相关。以年龄、性别、受教育年限和APOE状况为混杂因素进行统计分析。结果共分析了36例AD患者、44例MCI患者和31例健康对照。 Patients with AD had significantly higher total, WM, and basal ganglia PVSVF (Cohen d = 1.15–1.48; p < 0.001) and FW-WM (Cohen d = 0.73; p < 0.05) and a lower ALPS index (Cohen d = 0.63; p < 0.05) than healthy controls. Meanwhile, the MCI group only showed significantly higher total (Cohen d = 0.99; p < 0.05) and WM (Cohen d = 0.91; p < 0.05) PVSVF. Low ALPS index was associated with lower CSF Aβ42 (rs = 0.41, pfdr = 0.026), FDG-PET uptake (rs = 0.54, pfdr < 0.001), and worse multiple cognitive domain deficits. High FW-WM was also associated with lower CSF Aβ42 (rs = −0.47, pfdr = 0.021) and worse cognitive performances.Discussion Our study indicates that changes in PVS-related MRI parameters occur in MCI and AD, possibly due to impairment of the glymphatic system. We also report the associations between MRI parameters and Aβ deposition, neuronal change, and cognitive impairment in AD.Aβ=amyloid β; ADAS=Alzheimer's Disease Assessment Scale; ADNI=Alzheimer's Disease Neuroimaging Initiative; ALPS=diffusivity along the perivascular space; BG=basal ganglia; CDR-SB=Clinical Dementia Rating Scale Sum of Boxes; DBP=diastolic blood pressure; DTI=diffusion tensor imaging; DW=diffusion weighted; FA=fractional anisotropy; FAQ=Functional Activities Questionnaire; FDG=[18F] fluorodeoxyglucose; FLAIR=fluid-attenuated inversion recovery; FSL=FMRIB Software Library 6.0.3; FW=free water; GBCA=gadolinium-based contrast agent; GMVF=gray matter volume fraction; Hipp=hippocampus; HMSCORE=Modified Hachinski Ischemic Score; ISF=interstitial fluid; MCI=mild cognitive impairment; MMSE=Mini-Mental State Examination; PVS=perivascular space; PVSVF=PVS volume fraction; RAVLT=Rey Auditory Verbal Learning Test; ROI=region of interest; SBP=systolic blood pressure; SUVR=standardized uptake value ratio; T1w=T1 weighted; WM=white matter; WML=white matter lesion; WMLVF=white matter lesion volume fraction; WMVF=white matter volume fraction %U //www.ez-admanager.com/content/neurology/99/24/e2648.full.pdf