卡巴拉汀治疗阿尔茨海默病的脑局部一致性研究

Study of the Brain Regional Homogeneity Changes in Response to the Treatment with Rivastigmine in Alzheimer's Disease

关键词:  卡巴拉汀  静息态功能磁共振  局部一致性  阿尔茨海默病

Key words:  rivastigmine  resting-state functional magnetic resonance imaging  regional homogeneity  Alzheimer's disease

摘要:

目的 通过局部一致性（regional homogeneity，ReHo）分析方法探究卡巴拉汀治疗阿尔茨海默病（Alzheimer's disease，AD）的脑功能影像机制。方法 9例轻中度AD患者给予卡巴拉汀治疗24周，治疗前后分别进行全面的神经心理测评和静息态功能磁共振扫描。并选取年龄、性别、受教育年限与之相匹配的健康对照组9例进行静息态功能磁共振扫描，比较卡巴拉汀治疗前后AD患者大脑ReHo值的变化。结果 与治疗前比，AD患者治疗后，表现出简易智力状态检查量表评分增加（P<0.05），老年痴呆症评估量表-认知部分和日常生活活动能力评分降低（P<0.05）；AD患者在左内侧额上回，左侧眶内额上回和右侧杏仁核表现出ReHo值减少（P<0.05）；此外，老年痴呆症评估量表-认知部分得分变化与左侧眶内额上回ReHo值呈正相关。结论 卡巴拉汀能够改善AD的认知功能，可能是通过与认知相关的内侧额上回和杏仁核的自发脑活动来实现的，相关脑区未来有望作为此类药物疗效监测的生物学标志物。

Abstract:

OBJECTIVE To investigate the therapeutic mechanism of rivastigmine related to brain function by regional homogeneity(ReHo) in Alzheimer's disease(AD) patients. METHODS Treatment with rivastigmine was performed in 9 mild and moderate AD patients for 24 weeks. Before and after the treatment, they received comprehensive neuropsychological assessments and resting-state functional magnetic resonance imaging respectively. Meanwhile, resting-state functional magnetic resonance imaging was conducted on the healthy control group including 9 healthy individuals with the same age, gender and education with the aforesaid 9 AD patients, in an attempt to compare the changes in brain ReHo among the AD patients before and after the treatment with rivastigmine. RESULTS Compared with before treatment, after treatment of AD patients had an increase in their mini-mental state examination scores(P<0.05), while a decrease in scores of AD assessment scale-cognitive section and activity of daily living scale(P<0.05). The AD patients showed ReHo values reduced in the medial part of the left superior frontal gyrus, the medial orbital part of the left superior frontal gyrus and the right amygdala(P<0.05). In addition, the changes in scores of AD assessment scale-cognitive section were positive correlated with the ReHo values of the medial orbital part of the left superior frontal gyrus. CONCLUSION These findings suggest that rivastigmine's able to improve cognitive abilities of AD patients which may be achieved by altering spontaneous cerebration of the medial part of the superior frontal gyrus and the amygdala. Relevant brain regions are likely to serve as the biomarker for monitoring therapeutic effects of this kind of drugs in the future.