患有酒精使用障碍(AUD)的个体的脑结构形态学特征涉及边缘系统的破坏。体内成像研究报告了相对于对照组的AUD海马体积损失,但是直到最近才有可能表达这种复杂结构的不同区域。海马区的体积分析而不是海马总体积分析可能会增强疾病过程的分化。例如,海马亚区玉米氨1(CA1)的损伤通常在阿尔茨海默病(AD)中报道,而CA4/齿状回的缺陷被描述为对压力和创伤的反应。先前的两项研究探讨了长期饮酒对海马子场的影响:一项报告称,与对照组相比,酒精依赖受试者的CA23体积较小,与多年饮酒有关;另一个,较小体积的前丘,下膜,与对照男性相比,酒精依赖者的菌毛。目前的研究,在24名DSM5诊断为AUD的成年人中进行(7名女性,53.7±8.8)和20个对照(7名女性,54.1±9.3),是第一个使用FreeSurfer6.0的人,它提供了最先进的海马分裂,探讨海马区对酒精中毒的敏感性。在具有32通道Nova头线圈的GEMR750系统上收集T1和T2图像。FreeSurfer6.0海马子场分析产生了12个子场:副伞;前膜;下膜;CA1;CA23;CA4;GC-ML-DG(齿状回(DG)的颗粒细胞(GC)和分子层(ML);分子层;海马-杏仁核-过渡区(HATA);整个海马和海马campria;一系列全面的神经心理学测试,包括注意力,记忆和学习,视觉空间能力,执行职能被管理。按组对每个子场的原始体积数据进行多元回归分析,年龄,性别,半球,和幕上体积(svol)显示了svol(p<.04)对几乎所有结构(不包括尾巴和裂隙)的显着影响。经svol校正的卷显示了年龄的影响(菌毛,裂隙)和组(下丘,CA1,CA4,GC-ML-DG,HATA,纤毛);CA23显示出按年龄诊断的相互作用,表明年龄较大的AUD个体的体积小于其年龄预期的体积。海马亚区与神经心理学测试的表现之间没有选择性关系,可能是由于缺乏统计能力。目前的结果与先前的研究一致,认为CA2+3对酒精中毒敏感,通过识别酒精中毒与年龄的相互作用来扩展它们,并提示将AUD与AD和应激/创伤区分开的影像学表型。
The profile of brain structural dysmorphology of individuals with Alcohol Use Disorders (AUD) involves disruption of the limbic system. In vivo imaging studies report hippocampal volume loss in AUD relative to controls, but only recently has it been possible to articulate different regions of this complex structure. Volumetric analysis of hippocampal regions rather than total hippocampal volume may augment differentiation of disease processes. For example, damage to hippocampal subfield cornu ammonis 1 (CA1) is often reported in Alzheimer\'s disease (AD), whereas deficits in CA4/dentate gyrus are described in response to stress and trauma. Two previous studies explored the effects of chronic alcohol use on hippocampal subfields: one reported smaller volume of the CA2+3 in alcohol-dependent subjects relative to controls, associated with years of alcohol consumption; the other, smaller volumes of presubiculum, subiculum, and fimbria in alcohol-dependent relative to control men. The current
study, conducted in 24 adults with DSM5-diagnosed AUD (7 women, 53.7 ± 8.8) and 20 controls (7 women, 54.1 ± 9.3), is the first to use FreeSurfer 6.0, which provides state-of-the art hippocampal parcellation, to explore the sensitivity of hippocampal sufields to alcoholism. T1- and T2- images were collected on a GE MR750 system with a 32-channel Nova head coil. FreeSurfer 6.0 hippocampal subfield analysis produced 12 subfields: parasubiculum; presubiculum; subiculum; CA1; CA2+3; CA4; GC-ML-DG (Granule Cell (GC) and Molecular Layer (ML) of the Dentate Gyrus (DG)); molecular layer; hippocampus-amygdala-transition-area (HATA); fimbria; hippocampal tail; hippocampal fissure; and whole volume for left and right hippocampi. A comprehensive battery of neuropsychological tests comprising attention, memory and learning,
visuospatial abilities, and executive functions was administered. Multiple regression analyses of raw volumetric data for each subfields by group, age, sex, hemisphere, and supratentorial volume (svol) showed significant effects of svol (p < .04) on nearly all structures (excluding tail and fissure). Volumes corrected for svol showed effects of age (fimbria, fissure) and group (subiculum, CA1, CA4, GC-ML-DG, HATA, fimbria); CA2+3 showed a diagnosis-by-age interaction indicating older AUD individuals had a smaller volume than would be expected for their age. There were no selective relations between hippocampal subfields and performance on neuropsychological tests, likely due to lack of statistical power. The current results concur with the previous
study identifying CA2+3 as sensitive to alcoholism, extend them by identifying an alcoholism-age interaction, and suggest an imaging phenotype distinguishing AUD from AD and stress/trauma.