人体纹状体和苍白体的体积测定——解剖学、细胞结构、连接、MRI和衰老。

Sbornik lekarsky Pub Date : 2003-01-01
J Brabec, J Krásený, P Petrovický
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引用次数: 0

摘要

背景:为了比较病理和正常健康状态,必须获得足够的体积数据。然而,大多数公开的工作只使用少数健康对照,而不是患者来测量基底神经节体积。进一步的必要条件是在这种分析中考虑年龄对基底神经节体积的影响。目的:我们研究的目的是:(1)对中枢神经系统通路中基底神经节的结构、神经递质、连接和总体整合进行当前的回顾;(2)通过MRI和死后研究收集足够的体积数据,并指定纹状体和苍白质的体积;(3)评估成年健康患者这些结构的衰老情况。另一个目标是(4)检查基底神经节的大小与大脑体积特征、颅容量或中枢神经系统内经常测量的尺寸之间的相关性。尽管对于想要确定结构是否“正常”的临床医生来说,测量所有这些维度是不可能的。另一个目标是(5)找到一个简单的度量,它可以作为利息结构的实际规模的指标。方法:通过经典解剖方法和MRI检查,对108例(18-89岁)健康成人的纹状体(进一步分为尾状核-伏隔核-CD-Acc和壳核复合体)和苍白质进行了体积测定。从另一项测量中,我们计算出每个大脑的脑容量和体积特征。结果:一般认为,在不考虑年龄变化的情况下,纹状体、CD-Acc复合体、壳核和苍白球的绝对体积在两性和半球间的差异都不显著。在纹状体的情况下,两性的绝对体积在大小和年龄之间发现了显著的相关性(p < 0.0001)。在男性中,纹状体在20-50岁的年龄范围内体积下降约14.3%(每十年约4.8%)。在女性中,年龄相关的萎缩约为16.9%(每十年约5.6%)。女性复合体CD-Acc体积与年龄无统计学相关性(p = 0.061)。20 ~ 50岁女性壳核的年龄相关性下降约23.15%(7.7% / 10年)。在男性中,尾状核-伏隔核复核的癫痫发作减少了16.2%,在相同的年龄范围内(每十年5.4%)。同样,男性壳核体积在20-50岁之间减少12.3%(每十年减少4.1%)。在20-50岁的男性中,苍白球体积下降约21.6%(每十年7.2%)。在女性中,这一比例仅为11.5%(每十年3.8%)。前连合水平纹状体平面与纹状体总体积高度相关(p < 0.0001, r = 0.668)。纹状体体积在前连合水平(1cm厚片)的百分比在男性和女性之间没有统计学差异。在我们的数据中,它给出28.56% (SD = 3.05)。纹状体平面与年龄之间的相关性在两性中都是显著的(女性:p = 0.007, r = 0.348,男性:p = 0.029, r = 0.349),纹状体体积与年龄之间的相关性也是如此。结论:我们的研究结果表明,年龄对大脑中不同的结构有不同的反映。我们发现在两性中体积的减少是不相等的,甚至在特定的细胞核中也是如此。我们的研究结果还表明,基底神经节体积的减少与年龄的关系不是线性的,而是由没有变化的时期和体积减少的时期组成的。在纹状体的情况下,行为的变化看起来很相似(只有5年),而在苍白球的情况下,这种情况明显不同。我们的观察结果可能表明,大脑结构的衰老存在两性间的独特性。从一张MRI,从一张前连合水平的额叶切片可以减少每个被检查个体纹状体的总体积。简单的图显示间隔,其中该平面的正常值应依赖于被检查患者的年龄和性别。另一张图显示了纹状体的总体积。这些发现可以快速可靠地帮助更好地诊断不同的疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Volumetry of striatum and pallidum in man--anatomy, cytoarchitecture, connections, MRI and aging.

Background: For comparing of the pathological and normal healthy state it is essential to obtain sufficient amount of the volumetric data. Nevertheless most of the publicized works use only few healthy controls opposite to the patients for the measuring of the basal ganglia volume. Further essential condition is to take into account the effect of age to the basal ganglia volume in such analysis.

Purpose: The goal of our study was (1) to give the current review of the structure, neurotransmitters, connections and general integration of the basal ganglia in the pathways of the central nervous system, (2) aggregate sufficient amount of volumetric data by virtue of MRI and post-mortem studies, and appoint volumes of the striatum and pallidum, (3) evaluate aging of these structures in adult healthy patients. Another goal was (4) to inspect the correlations between the size of the basal ganglia and volume characteristics of the brain, cranial capacity or frequently measured dimensions within CNS. In the spite of the fact that it is not possible to measure all of these dimensions for clinicians who want to determine if the structure is "normal" or not. Another goal was (5) to find a simple measure, which could serve as the indicator of the real size of structure of the interest.

Methods: By virtue of the classical anatomical methods and MRI examination we appointed volumes of the striatum (furthermore divided into the complex of the caudatum--nucleus accumbens--CD-Acc and putamen) and pallidum in the sample of 108 healthy adults (18-89 years old). From another measurements we calculated the cranial capacity and volume characteristics of each brain.

Results: In a general view that does not respect changes due to age neither volumetric difference between two sexes nor interhemispheric difference was significant for absolute volumes of the striatum, CD-Acc complex, putamen and pallidum. In the case of the striatum, significant correlation between size and age was found (p < 0.0001) for absolute volumes in both sexes. In men, striatum showed a decrease about 14.3% in volume in the 20-50-year age range (about 4.8% per decade). In woman, the age related shrinkage is about 16.9% (about 5.6% per decade). Dependence on age was not statistically proven for volume of female complex CD-Acc (p = 0.061). Age related decrease of female putamen was about 23.15% in the 20-50 year age range (7.7% per decade). In men, the seizure decrease of the caudate--accumbens complex amounts 16.2%, in the same age range (5.4% per decade). Similarly, volume of the putamen in men decreases up to 12.3% between 20-50 years of age (4.1% per decade). In men, the pallidum showed a decrease about 21.6% in volume in the 20-50-year age range (7.2% per decade). In women, it amounts only 11.5% (3.8% per decade). Plane of the striatum in the level of the commissura anterior showed high correlation with total striatal volume (p < 0.0001, r = 0.668). The percentual portion of striatal volume at the level of the commissura anterior (1 cm thick slice) does not differ statistically between males and females. In our data it gives 28.56% (SD = 3.05). Correlation between the striatal planes and age was significant in both sexes (in women: p = 0.007, r = 0.348, and in men: p = 0.029, r = 0.349) as in the case of the correlation between striatal volume and age.

Conclusions: Our findings suggest that age mirror differently on separate structures in the brain. We have found unequal volume decrease within both sexes even particular nuclei. Our findings also suggest that decrease of the basal ganglia volume in the dependence on age is not linear but it is composed from periods without changes and periods with reduction of its size. In the case of the striatum, behaviour of changes looks similar (with only 5 years), while in the case of the pallidum this situation is markedly different. Our observations may suggest intersexual singularity in the aging of brain structures. From one MRI, from one frontal slice in the level of the commissura anterior is possible to reduce total volume of the striatum for every examined individual. Simple graph shows interval, where the normal value of this plain should be in dependency on age and sex of the examined patient. Another graph allows reducing from this plane the total volume of the striatum. These findings can be the quick and reliable aid in better diagnostics of different diseases.

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