ApoEε4基因结合sMRI对不同亚型轻度认知功能障碍的研究

摘要

Objective To evaluate demographics,neuropsychological performance,structural magnetic resonance imaging (sMRI) measures,and apolipoprotein E genotype among four mild cognitive impairment (MCI) subtypes.Methods A total of 94 subjects with MCI and 53 cognitively normal older participants (controls) were evaluated.Classification of subjects with MCI into four subtypes based on neuropsychological performance,were investigated about sMRI research and ApoEε4 genotype.Medial temporal lobe atrophy (MTA) and prevalence of white matter hyperintensity (WMH) were assessed by sMRI.In addition,to study the relationship between Minimum Mental State Examination (MMSE) score,MTA score and ApoEε4 score,WMH and MCI subtypes.Results Severity of MMSE and MTA differed among MCI subtypes and control group.We found that 2 amnestic forms of MCI patients had significantly higher MTA scores than the 2 nonamnestic forms of MCI patients.However,there are not significant differences in WMH among the MCI subtypes.Apolipoprotein E genotype prevalence was significantly higher in the amnestic compared with nonamnestic subtypes of MCI.In addition,in amnestic MCI-single domain (aMCI-SD) and amnestic MCI-multiple domain (aMCI-MD) subjects,presence of ApoEε4 allele had a significant impact on the severity of MTA and memory deficits.Conclusion The different subtypes of MCI,may display biological heterogeneity,suggesting that sMRI in combination with the ApoEε4 genotype might be more helpful to predict progression from MCI to dementia.%目的 评价4种不同轻度认知障碍亚型之间人口统计学、心理特点、结构性磁共振成像(structural magnetic resonance imaging,sMRI)及载脂蛋白Eε4(apolipoprotein Eε4,ApoEε4)的特点.方法 对94例轻度认知障碍的老年人,与53例认知程度正常老年人作为对照组进行评价.4种轻度认知障碍(mild cognitive impairment,MCI)基于神经心理学表现分类,颞叶内侧面萎缩(medial temporal lobe atrophy,MTA)和脑白质高信号(white matter hyperintensity,WMH)通过sMRI评估.另外,研究简易精神状态检查表(Minimum Mental State Examination,MMSE)评分、MTA评分、WMH和MCI亚型间与ApoEε4关系.通过sMRI评估.结果 在不同亚型的MCI及对照组之间其MMSE评分、MTA差异有统计学意义,遗忘型轻度认知障碍(amnestic MCI,aMCI)亚型与非遗忘型轻度认知障碍亚型(non-amnestic MCI,naMCI)相比,MTA评分明显增加.然而,WMH无明显差异.ApoEε4基因在aMCI及naMCI亚型中显著增加.结论 MCI不同亚型可显示生物异质性,sMRI结合ApoEε4可以协同预测MCI向痴呆的发展.