PDF(Pubmed)
Abstract：
BACKGROUND: Patients with Alzheimer\'s Disease (AD) exhibit structural alterations of the thalamus that correlate with clinical symptoms. However, given the anatomical complexity of this brain structure, it is still unclear whether atrophy affects specific thalamic nuclei and modulates the clinical progression from a prodromal stage, known as Mild Cognitive Impairment (MCI), to full-fledged AD.
OBJECTIVE: To characterize the structural integrity of distinct thalamic nuclei across the AD spectrum, testing whether MCI patients who convert to AD (c-MCI) show a distinctive pattern of thalamic structural alterations compared to patients who remain stable (s-MCI).
METHODS: Investigating between-group differences in the volumetric features of distinct thalamic nuclei across the AD spectrum.
METHODS: Prodromal and clinical stages of AD.
METHODS: We analyzed data from 84 healthy control subjects (HC), 58 individuals with MCI, and 102 AD patients. The dataset was obtained from the AD Neuroimaging Initiative (ADNI-3) database. The MCI group was further divided into two subgroups depending on whether patients remained stable (s-MCI, n=22) or progressed to AD (s-MCI, n=36) in the 48 months following the diagnosis.
METHODS: A multivariate analysis of variance (MANOVA) assessed group differences in the volumetric features of distinct thalamic nuclei obtained from magnetic resonance (MR) images. A stepwise discriminant function analysis identified which feature most effectively predicted the conversion to AD. The corresponding predictive performance was evaluated through a Receiver Operating Characteristic approach.
RESULTS: AD and c-MCI patients showed generalized atrophy of thalamic nuclei compared to HC. In contrast, no significant structural differences were observed between s-MCI and HC subjects. Compared to s-MCI, c-MCI individuals displayed significant atrophy of the nucleus reuniens and a trend toward significant atrophy in the anteroventral and laterodorsal nuclei. The discriminant function analysis confirmed the nucleus reuniens as a significant predictor of AD conversion, with a sensitivity of 0.73 and a specificity of 0.69.
CONCLUSIONS: In line with the pathophysiological relevance of the nucleus reuniens proposed by seminal post-mortem studies on patients with AD, we confirm the pivotal role of this nucleus as a critical hub in the clinical progression to AD. We also propose a theoretical model to explain the evolving dysfunction of subcortical brain networks in the disease process.
OBJECTIVE: To characterize the structural integrity of distinct thalamic nuclei across the AD spectrum, testing whether MCI patients who convert to AD (c-MCI) show a distinctive pattern of thalamic structural alterations compared to patients who remain stable (s-MCI).
METHODS: Investigating between-group differences in the volumetric features of distinct thalamic nuclei across the AD spectrum.
METHODS: Prodromal and clinical stages of AD.
METHODS: We analyzed data from 84 healthy control subjects (HC), 58 individuals with MCI, and 102 AD patients. The dataset was obtained from the AD Neuroimaging Initiative (ADNI-3) database. The MCI group was further divided into two subgroups depending on whether patients remained stable (s-MCI, n=22) or progressed to AD (s-MCI, n=36) in the 48 months following the diagnosis.
METHODS: A multivariate analysis of variance (MANOVA) assessed group differences in the volumetric features of distinct thalamic nuclei obtained from magnetic resonance (MR) images. A stepwise discriminant function analysis identified which feature most effectively predicted the conversion to AD. The corresponding predictive performance was evaluated through a Receiver Operating Characteristic approach.
RESULTS: AD and c-MCI patients showed generalized atrophy of thalamic nuclei compared to HC. In contrast, no significant structural differences were observed between s-MCI and HC subjects. Compared to s-MCI, c-MCI individuals displayed significant atrophy of the nucleus reuniens and a trend toward significant atrophy in the anteroventral and laterodorsal nuclei. The discriminant function analysis confirmed the nucleus reuniens as a significant predictor of AD conversion, with a sensitivity of 0.73 and a specificity of 0.69.
CONCLUSIONS: In line with the pathophysiological relevance of the nucleus reuniens proposed by seminal post-mortem studies on patients with AD, we confirm the pivotal role of this nucleus as a critical hub in the clinical progression to AD. We also propose a theoretical model to explain the evolving dysfunction of subcortical brain networks in the disease process.
摘要：
背景：阿尔茨海默病（AD）患者表现出与临床症状相关的丘脑结构改变。然而,考虑到大脑结构的解剖复杂性，目前尚不清楚萎缩是否会影响特定的丘脑核，并从前驱阶段调节临床进展，被称为轻度认知障碍(MCI)，完整的AD。
目的：为了表征整个AD光谱中不同丘脑核的结构完整性，测试转换为AD的MCI患者(c-MCI)与保持稳定的患者(s-MCI)相比是否显示出独特的丘脑结构改变模式。
方法：研究AD光谱中不同丘脑核体积特征的组间差异。
方法：AD的前驱期和临床分期。
方法：我们分析了来自84名健康对照受试者（HC）的数据，58名MCI患者和102名AD患者。数据集从AD神经成像计划(ADNI-3)数据库获得。根据患者在诊断后48个月内是否保持稳定（s-MCI，n=22）或进展为AD（s-MCI，n=36），将MCI组进一步分为两个亚组。
方法：多变量方差分析（MANOVA）评估了从磁共振（MR）图像获得的不同丘脑核的体积特征的组差异。逐步判别函数分析确定了哪个特征最有效地预测了向AD的转化。通过接收器工作特性方法评估了相应的预测性能。
结果：与HC相比，AD和c-MCI患者显示丘脑核的广泛性萎缩。相比之下,在s-MCI和HC受试者之间没有观察到显著的结构差异.与s-MCI相比，c-MCI个体显示出细胞核的显着萎缩，并且在前腹核和后背核中有明显萎缩的趋势。判别函数分析证实了细胞核是AD转化的重要预测因子，灵敏度为0.73，特异性为0.69。
结论：根据对AD患者进行的精液验尸研究提出的核重组的病理生理相关性，我们证实了该细胞核作为AD临床进展的关键枢纽的关键作用.我们还提出了一个理论模型来解释皮质下脑网络在疾病过程中不断发展的功能障碍。
目的：为了表征整个AD光谱中不同丘脑核的结构完整性，测试转换为AD的MCI患者(c-MCI)与保持稳定的患者(s-MCI)相比是否显示出独特的丘脑结构改变模式。
方法：研究AD光谱中不同丘脑核体积特征的组间差异。
方法：AD的前驱期和临床分期。
方法：我们分析了来自84名健康对照受试者（HC）的数据，58名MCI患者和102名AD患者。数据集从AD神经成像计划(ADNI-3)数据库获得。根据患者在诊断后48个月内是否保持稳定（s-MCI，n=22）或进展为AD（s-MCI，n=36），将MCI组进一步分为两个亚组。
方法：多变量方差分析（MANOVA）评估了从磁共振（MR）图像获得的不同丘脑核的体积特征的组差异。逐步判别函数分析确定了哪个特征最有效地预测了向AD的转化。通过接收器工作特性方法评估了相应的预测性能。
结果：与HC相比，AD和c-MCI患者显示丘脑核的广泛性萎缩。相比之下,在s-MCI和HC受试者之间没有观察到显著的结构差异.与s-MCI相比，c-MCI个体显示出细胞核的显着萎缩，并且在前腹核和后背核中有明显萎缩的趋势。判别函数分析证实了细胞核是AD转化的重要预测因子，灵敏度为0.73，特异性为0.69。
结论：根据对AD患者进行的精液验尸研究提出的核重组的病理生理相关性，我们证实了该细胞核作为AD临床进展的关键枢纽的关键作用.我们还提出了一个理论模型来解释皮质下脑网络在疾病过程中不断发展的功能障碍。
