% 0期刊文章%一个塞雷娜威尔第%赛义德Mostafa起亚% Keir X.X.勇% Duygu Tosun %乔纳森·m·Schott %安德烈·f·Marquand %詹姆斯·h·科尔% T揭示个体神经解剖学的异质性在阿尔茨海默病神经解剖学的规范性建模% D R 10.1212 / WNL 2023%。0000000000207298 % J半岛投注体育官网神经病学% P e2442-e2453 % V 100% N 24% X背景和目标阿尔茨海默病(AD)是高度异构的、显著的个体差异在临床表现和神经生物学。探索这个,我们使用神经解剖学的规范性建模在皮质厚度指数区域模式的可变性。我们旨在描述个体差异和离群值在AD患者皮质厚度,轻度认知障碍(MCI)患者和控制。此外,我们评估了皮质厚度的异质性和认知功能之间的关系,β-amyloid phosphorylated-tau, ApoE基因型。最后,我们检查是否皮质厚度的异质性是遗忘型MCI向AD转换的预测。皮质厚度测量方法得到了148个大脑区域从t1加权磁共振扫描从62年的阿尔茨海默病的神经影像学的网站。广告是由临床和神经心理学检查无并发症出现。参与者与MCI投诉报告内存,和控制认知正常。神经解剖学的规范性模型索引皮质厚度分布使用一个独立的健康参考数据组(n = 33072),使用分层贝叶斯回归预测皮质厚度每地区使用年龄和性别,而调整网站的噪音。每个地区z得分计算,导致z分数每个参与者大脑地图。 Regions with Z-scores <−1.96 were classified as outliers.Results Patients with AD (n = 206) had a median of 12 outlier regions (out of a possible 148), with the highest proportion of outliers (47%) in the parahippocampal gyrus. For 62 regions, over 90% of these patients had cortical thicknesses within the normal range. Patients with AD had more outlier regions than people with MCI (n = 662) or controls (n = 159) (F(2, 1,022) = 95.39, p = 2.0 × 10−16). They were also more dissimilar to each other than people with MCI or controls (F(2, 1,024) = 209.42, p = 2.2 × 10−16). A greater number of outlier regions were associated with worse cognitive function, CSF protein concentrations, and an increased risk of converting from MCI to AD within 3 years (hazard ratio 1.028, 95% CI 1.016–1.039, p = 1.8 × 10−16).Discussion Individualized normative maps of cortical thickness highlight the heterogeneous effect of AD on the brain. Regional outlier estimates have the potential to be a marker of disease and could be used to track an individual's disease progression or treatment response in clinical trials.Aβ=β-amyloid; AD=Alzheimer disease; ADNI=Alzheimer's Disease Neuroimaging Initiative; FDR=false discovery rate; IQR=interquartile range; MCI=mild cognitive impairment; MMSE=Mini-Mental State Examination; OASIS=Open Access Series of Imaging Studies; p-tau=phosphorylated-tau; tOC=total outlier count; UCSF=University of California, San Francisco; UKB=UK Biobank %U //www.ebmtp.com/content/neurology/100/24/e2442.full.pdf