알츠하이머병 및 피질하허혈성혈관치매 환자들의 국소 뇌 부피 정량 비교
Comparison of Regional Brain Volume of Alzheimer’s Disease and Subcortical Ischemic Vascular Dementia
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Background: The findings like the brain atrophy and ventricular dilatation can be also shown on magnetic resonance imaging (MRI) of the patients with subcortical ischemic vascular dementia (SIVD) as well as Alzheimer’s disease (AD), and some patients with SIVD have the pathology of AD. There have been also objected to that SIVD is not the true vascular dementia (VaD), but the mixed type with AD. We compared the regional volumes of the gray and white matters between AD and SIVD with the hypothesis that the brain atrophy of the patients with SIVD shown on MRI is a relative result from the atrophy of the white matter, not from the atrophy of the gray matter. Methods: Twelve AD patients and 13 SIVD patients were included in this study. Eleven controls without the cognitive impairment were also included. The volumes of the bilateral frontal, temporal, parietal areas, and the bilateral hippocampus and entorhinal cortex were obtained. After the correction with the ratio to the intracranial volume, the regional volumes were compared among AD, SIVD and the controls by analysis of variances with multiple comparisons. Results: Whole brain volume of the patients with AD was the smallest (p=0.042). The ventricular volumes of the patients with AD and SIVD were smaller than that of the controls (p=0.001). For the volumes of frontal, temporal and parietal regions were not different. The volumes of the bilateral hippocampus (p=0.009) and entorhinal cortex (p=0.002 in the right side and p=0.001 in the left side) were the lowest in the AD patients. The left entorhinal cortex of AD patients was smaller also compared to that of SIVD. Conclusions: The brain atrophy and the ventricular dilatation can be observed in SIVD as well as in AD. However, these findings of SIVD are not from the cortical atrophy such as the hippocampus and entorhinal cortex, which is responsible for AD, and might be from the lesions of the white matters.
Abstract
Background: The findings like the brain atrophy and ventricular dilatation can be also shown on magnetic resonance imaging (MRI) of the patients with subcortical ischemic vascular dementia (SIVD) as well as Alzheimer’s disease (AD), and some patients with SIVD have the pathology of AD. There have been also objected to that SIVD is not the true vascular dementia (VaD), but the mixed type with AD. We compared the regional volumes of the gray and white matters between AD and SIVD with the hypothesis that the brain atrophy of the patients with SIVD shown on MRI is a relative result from the atrophy of the white matter, not from the atrophy of the gray matter. Methods: Twelve AD patients and 13 SIVD patients were included in this study. Eleven controls without the cognitive impairment were also included. The volumes of the bilateral frontal, temporal, parietal areas, and the bilateral hippocampus and entorhinal cortex were obtained. After the correction with the ratio to the intracranial volume, the regional volumes were compared among AD, SIVD and the controls by analysis of variances with multiple comparisons. Results: Whole brain volume of the patients with AD was the smallest (p=0.042). The ventricular volumes of the patients with AD and SIVD were smaller than that of the controls (p=0.001). For the volumes of frontal, temporal and parietal regions were not different. The volumes of the bilateral hippocampus (p=0.009) and entorhinal cortex (p=0.002 in the right side and p=0.001 in the left side) were the lowest in the AD patients. The left entorhinal cortex of AD patients was smaller also compared to that of SIVD. Conclusions: The brain atrophy and the ventricular dilatation can be observed in SIVD as well as in AD. However, these findings of SIVD are not from the cortical atrophy such as the hippocampus and entorhinal cortex, which is responsible for AD, and might be from the lesions of the white matters.
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