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阿尔茨海默病和轻度认知功能障碍患者胆碱能激发对海马活性的不同影响:一项药理学f.RI研究

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世界核心医学期刊文摘(神经病学分册) 2006年第4期 36-37页

作者： Goekoop R. Scheltens P. barkhof f. Rombouts S.A.R.B. 樊慧婷 Department of.Neurology De Boelelaan 1117 1081 HV Amsterdam Netherlands.Dr

Pharmacological f.nctional MRI (phMRI) examines the impact of.pharmacologically induced neurochemical changes on brain f.nction at a system level. The current phMRI study directly compared ef.ects of.cholinergic stimulation on brain f.nction between patients with Alzheimer's disease and mild cognitive impairment, a disease stage preceding the development of.Alzheimer's disease. Brain f.nction during recognition of.(un)f.miliar inf.rmation was examined f.r changes af.er exposure to galantamine, a cholinesterase inhibitor used f.r treating memory def.cits in Alzheimer's disease. Alzheimer patients [n = 18; age 74.5 years ± 8.2; Mini-Mental State Examination (MMSE) 22.5 ± 2.4] and patients with mild cognitive impairment (n = 28; mean age 73.6 ± 7.5; MMSE 27.0 ± 1.2) were scanned during f.ce recognition under three dif.erent conditions: at baseline, and af.er acute (single dose) and prolonged exposure (5 days) to galantamine. f.nctional data were analysed in an event-related f.shion. In both groups, acute exposure produced strong increases in brain activation (Z >3.1). Prolonged exposure produced less strong ef.ects that mainly involved decreases in activation (Z >3.1). In mild cognitive impairment, acute exposure increased activation in posterior cingulate, lef. inf.rior parietal, and anterior temporal lobe. Prolonged exposure decreased activation in similar posterior cingulate areas, and in bilateral pref.ontal areas. Ef.ects were stronger f.r positive (‘ f.miliar') than f.r negative (‘ unf.miliar') decisions, indicating that the ef.ect was specif.c to memory retrieval. In Alzheimer patients, acute exposure increased activation bilaterally in hippocampal areas, whereas prolonged exposure decreased activation in these areas. Ef.ects were more pronounced f.r negative than f.r positive decisions, suggesting a pref.rential ef.ect on memory encoding. Unique prof.les of.signal reactivity were f.und in a number of.areas, including lef. inf.rior parietal lobe and lef. hippoca

关键词：轻度认知功能障碍阿尔茨海默病胆碱能系统药理学药物学患者

非残疾老年人的中央颞叶萎缩和白质高信号与轻度认知功能障碍相关:LADIS研究

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世界核心医学期刊文摘(神经病学分册) 2006年第2期 37-38页

作者： Van Der f.ier W.M. Van Straaten E.C.W. barkhof f. 赵天智 Department of.Neurology and Alzheimer Centre Vrije Universiteit Medical Centre PO Box 7057 1007 MB Amsterdam Netherlands.Prof

Objective: To assess the associations of.medial temporal lobe atrophy (MTA) and white matter hyperintensities (WMH) with cognitive f.nction in a large group of.independently f.nctioning elderly people. Methods: Data were drawn f.om the multicentre, multinational leukoaraiosis and disability (LADIS) project which is s tudying prospectively the role of.WMH as an independent predictor of.the transit ion to disability in non-disabled elderly people. In all, 639 participants were enrolled in the LADIS study. f.r the present analysis, data on 581 subjects wer e available. Cognitive f.nction was assessed by the minimental state examination (MMSE). Visual ratings of.WMH and MTA were undertaken on magnetic resonance ima ges (MRI). Results: The presence of.either severe WMH or MTA was associated with a modest but non-signif.cant increase in f.equency of.mild cognitive def.cits (severe WMH: odds ratio (OR) = 1.9 (95%conf.dence interval (CI), 1.0 to 3.7); MTA present: OR = 1.5 (95%CI, 1.8 to 2.8)). However, subjects with the combination of.MTA and se vere WMH had a more than f.urf.ld increase in f.equency of.mild cognitive def.ci ts (OR = 4.1 (95%CI, 2.3 to 7.4)). Analysis of.variance with post hoc Bonf.rron i t tests showed that subjects with both MTA and severe WMH perf.rmed worse on M MSE than those with either no MRI abnormality or a single MRI abnormality (p f.rther evidence f.r the combined invol vement of.both Alzheimer type pathology and vascular pathology in the earliest s tages of.cognitive decline and suggest an additive ef.ect of.WMH and MTA.

关键词：轻度认知功能障碍高信号 LADIS 颞叶大脑皮质白质髓质残疾老年人

阿尔茨海默病患者大脑白质损伤的进展:一种新的治疗窗

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世界核心医学期刊文摘（神经病学分册） 2005年第12期1卷 50-50页

作者： De Leeuw f.-E. barkhof f. Scheltens P. 黄媛 Dr.Department of.Neurology (HP326) University Medical Centre St. Radboud PO Box 9101 6500HB Nijmegen Netherlands

Background: White matter lesions (WML) are a risk f.ctor f.r Alzheimer’s disease. Progression of.WML is associated with vascular f.ctors and cognitive decline in population based studies but the course of.WML is unknown in Alzheimer’s disease. Abstract:Objective: To investigate the prevalence and risk f.ctors f.r progression of.WML in Alzheimer’s disease. Subjects: 38 patients with Alzheimer’s disease f.r whom blood pressure measurements and sequential brain MRIs were available. Methods: The proportion of.patients with progression of.WML was calculated, stratif.ed on baseline absence or presence of.WML by analysis of.variance. Odds ratios (OR) were calculated by age and sex adjusted logistic regression to quantif. the relation between blood pressure and progression of.WML. Results: About 25%of.the patients showed progression of.WML. Patients with WML at baseline had signif.cantly more progression than those without WML at baseline (adjusted mean dif.erence = 1.2; 95%conf.dence interval (CI), 0.6 to 1.8). Diastolic blood pressure (DBP) was particularly related to progression of.WML (OR = 5.9 (95%CI, 1.0 to 37.6) per 10 mm Hg DBP, p = 0.05). Conclusions: Alzheimer’s disease patients with WML at baseline are at risk f.r rapid progression of.WML. WML may of.er a potential treatment target in this disease to ameliorate the rate of.cognitive decline.

关键词：阿尔茨海默病脑白质损伤治疗窗认知功能比值比回归方法方差分析

采用laquinimod治疗复发性多发性硬化症减少MRI活动病灶进展

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世界核心医学期刊文摘（神经病学分册） 2005年第8期1卷 60-60页

作者： Polman C. barkhof f. Sandberg-WollheimM. 张玉龙 Department of.Neurology VU Medical Centre deBoelelaan 1117 NL-1007 MB Amsterdam Netherlands Dr.

Background: Laquinimod is a novel immunomodulatory substance developed as an o rally available disease modif.ing treatment in multiple sclerosis (MS). The purp ose of.this study was to evaluate saf.ty, tolerability, and ef.icacy on MRI lesi ons of.two dif.erent doses of.laquinimod compared with placebo in patients with relapsing MS. Methods: In this multicenter, double-blind, randomized trial, pat ients with relapsing MS received 0.1 mg or 0.3 mg laquinimod or placebo as three daily tablets f.r 24 weeks. Gadolinium-enhanced brain MRI scans were perf.rmed at screening, every eighth week during treatment, and 8 weeks af.er end of.trea tment. The primary ef.icacy variable was the cumulative number of.active lesions over 24 weeks. Saf.ty measures included adverse events, physical examination, a nd laboratory variables. Results: Of.256 screened patients, 209 were randomized (67 to 74 patients per group) in 20 *** was a signif.cant dif.erence b etween laquinimod 0.3 mg and placebo f.r the primary outcome measure (mean cumul ative number of.active lesions reduced by 44%). In the subgroup of.patients wit h at least one active lesion at baseline the reduction was slightly more pronoun ced (52%). No dif.erences with respect to clinical variables (relapses, disabil ity) were *** saf.ty prof.le was f.vorable; there were no clinical signs o f.undesired inf.ammatory manif.stations. Conclusion: Oral laquinimod in a dosage of.0.3 mg daily was well tolerated and ef.ective in suppressing development of.active lesions in relapsing multiple sclerosis.

关键词：多发性硬化症 MRI laquinimod 安慰剂体格检查化验指标口服片剂安全性评估双盲随机预后指标

无残疾老年人的小血管病变和总体认知功能:LADIS研究

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世界核心医学期刊文摘（神经病学分册） 2006年第3期2卷 39-39页

作者： Van Der f.ier W.M. Van Straaten E.C.W. barkhof f. 谢琰臣 Department of.Neurology Alzheimer Center Vrije Universiteit Medical Center PO Box 7057 1007 MB Amsterdam Netherlands

Background and Purpose -On cerebral magnetic resonance imaging (MRI), white matter hyperintensities (WMH) and lacunes are generally viewed as evidence of.small vessel disease. The clinical signif.cance of.small vessel disease in terms of.global cognitive f.nction has as yet not been completely clarif.ed. We investigated the independent contribution of.WMH and lacunes to general cognitive f.nction in a group of.independently living elderly with varying degrees of.small vessel disease. Methods -Data were drawn f.om the multicenter, multinational Leukokraurosis and Disability (LADIS) study. There were 633 independently living participants. General cognitive f.nction was assessed using the Mini Mental State Examination (MMSE) and the modif.ed Alzheimer Disease Assessment Scale (ADAS). On MRI, WMH was rated as mild, moderate, or severe. Lacunes were rated as none, f.w (1 to 3), or many (4 or more). Results -In the basic analysis, increasing severity of.both WMH and lacunes was related to deteriorating score on the MMSE and ADAS. When WMH and lacunes were entered simultaneously, both MRI measures remained signif.cantly associated with MMSE score. Increasing severity of.WMH remained associated with ADAS score, whereas the association with lacunes became less prominent. These associations were independent of.other risk f.ctors f.r dementia, like education, depression, vascular risk f.ctors, or stroke. Conclusion -We f. und WMH and lacunes to be independently associated with general cognitive f.ncti on in a sample of.independently living elderly. These results highlight the f.ct that WMH and lacunes should both be evaluated when assessing small vessel disea se in relation to cognitive f.nction.

关键词：认知功能 LADIS 小血管病变独立生活能力脑白质疏松症阿尔茨海默病血管危险因素磁共振成像

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更好地利用脑MRI研究数据

国际医学放射学杂志 2012年第5期 492-493页

作者： f.barkhof 高峰 Department of.Radiology VU University Medical CenterAmsterdamThe Netherlands

摘要MRI成像已经不仅仅局限在确定疾病的诊断,正越来越多地被用于研究脑的生理或脑成熟及衰老的生物机制。在逐渐老龄化的时代,与老化相关的脑变化的研究对理解神经退行性疾病(如阿尔茨海默病)的危险因素及早期指征是非常重要的。为了... 详细信息

摘要MRI成像已经不仅仅局限在确定疾病的诊断,正越来越多地被用于研究脑的生理或脑成熟及衰老的生物机制。在逐渐老龄化的时代,与老化相关的脑变化的研究对理解神经退行性疾病(如阿尔茨海默病)的危险因素及早期指征是非常重要的。为了检测脑结构的细微改变,例如为了检测一些罕见或微弱的遗传特性对脑结构的影响,就特别需要大型的影像数据库。

关键词： MRI www 元数据数据库数据库系统阿尔茨海默病

扩散加权成像与常规MR成像在新生儿缺氧缺血中的应用:2年的随访研究

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国际医学放射学杂志 2009年第1期32卷 67-68页

作者： R.J. Vermeulen P.E. van Schie L. Hendrikx f. barkhof M. van Weissenbruch D.L. Knol 李志明 Department of.Child Neurology VU University Medical Center Amsterdam the Netherlands

目的通过对缺血缺氧的新生儿2年后临床预后的评估，明确扩散加权成像（DWI）对于常规MR成像的信息补充价值。材料和方法 46例缺血缺氧新生儿作为本项前瞻性研究对象．年龄在出生后1～45d不等。这项研究经过了当地伦理委员会的认可，... 详细信息

目的通过对缺血缺氧的新生儿2年后临床预后的评估，明确扩散加权成像（DWI）对于常规MR成像的信息补充价值。材料和方法 46例缺血缺氧新生儿作为本项前瞻性研究对象．年龄在出生后1～45d不等。这项研究经过了当地伦理委员会的认可，告知患儿家属并获得同意。在大脑14个不同的区域测定表观扩散系数（ADC）。

关键词：新生儿缺氧缺血扩散加权成像 MR成像随访研究表观扩散系数缺血缺氧伦理委员会临床预后

临床神经放射中高场MRI的诊断相关问题:“驾驶一辆跑车”的优势与挑战

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国际医学放射学杂志 2013年第1期 82-82页

作者： M.P.Wattjes f.barkhof 柴超 Department of.Radiology VU University Medical CenterDe Boelelaan 11171081 HVAmsterdamThe Netherlands

理论上一些疾病在更高的磁场强度下可获得更高的诊断准确率,因而3T高场磁共振设备在神经影像领域内的应用逐步增加。本文编辑就有关Wardlaw及其同事比较3T与1.5T磁共振设备在神经放射学中应用的详尽综述进行了讨论。结果发现使用3T代替1... 详细信息

理论上一些疾病在更高的磁场强度下可获得更高的诊断准确率,因而3T高场磁共振设备在神经影像领域内的应用逐步增加。本文编辑就有关Wardlaw及其同事比较3T与1.5T磁共振设备在神经放射学中应用的详尽综述进行了讨论。结果发现使用3T代替1.5T进行MR成像后,并没有改善影像质量、提高诊断准确率和减少检查时间的确切证据。由于目前新一代的高场7TMR成像设备开始出现,故这些发现更具意义。

关键词：神经放射高场 MRI

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阿尔茨海默病患者的海马萎缩:年龄问题

世界核心医学期刊文摘(神经病学分册) 2006年第11期 50-50页

作者： Van De Pol L.A Hensel A barkhof f.郭俊 VU Medical Center Department of Neurology Box 7057 1007 MB Amsterdam Netherlands Dr.

Hippocampal atrophy is a marker of.Alzheimer disease (AD). It remains unclear whether this holds true f.r younger patients as well. Hippocampal volume was measured on MRI scans of.103 clinically diagnosed AD patients and 73 controls (aged 51 to 85 years). Aging and AD were independently associated with smaller hippocampal volume. Both young and old AD patients have hippocampal atrophy abnormal f.r age. Age-dependent criteria f.r hippocampal atrophy, suggestive of.AD, are needed.

关键词：阿尔茨海默病海马边缘系统患者