Apathy And Structural Changes Of Frontal-subcortical Circuits In Patients With Amnestic Mild Cognitive Impairment

Objective To investigate the relationship between region of interest(ROI)and apathy symptom of amnestic mild cognitive impairment(a MCI)patients and Alzheimer's dementia(AD)patients based on voxel-based morphological analysis(VBM)and surface-based morphological analysis(SBM),and to explore whether there is a correlation between the degree of atrophy and apathy.Methods 40 a MCI patients and 19 AD patients were recruited from Affiliated Zhongshan Hospital Dalian University.A1l Subjects were evaluated by a trained neuropsychology evaluator for assessment of cognitive,and diagnosed by using AES-I for apathy.The T1-weighted high-resolution(1×1×1mm~3)structural magnetic resonance of the patient was collected using Siemens 3.0T MRI machine.The CAT12 of MATLAB software was used to analyze the volume,thickness and white matter volume of each ROI,and to find ROIs with statistical differences in volume or thickness between different groups.Results1.Neuropsychological scale results:The AES score of the AD-a group was higher than that of the AD-na group,and there was no statistical difference in the remaining scores.The MMSE and Mo CA scores in the AD group were lower than those in the a MCI group,and the AES score and HAMD score were higher than those in the a MCI group,which were statistically different(p<0.05).The total score of AES-I and each domain area are negatively correlated with MMSE and Mo CA,and positively correlated with HAMD scores(p<0.001).The depression score in AES-I was positively correlated with HAMD scores,and was statistical significant(p<0.001).2.Statistical analysis of VBM results:The left anterior cingulate gyrus,bilateral frontal lobe cover,right frontal gyrus,and bilateral central island cover in the a MCI-a group have a smaller volume than the a MCI-na group(p<0.05).The right caudate nucleus,right medial orbital gyrus,right acicular nucleus,right anterior orbital gyrus,and right anterior cingulate gyrus in the AD-a group is smaller than AD-na group(p<0.05)3.Statistical analysis of SBM results:The bilateral lingual,bilateral pars triangularis,right caudal middle frontal,and right middle lorbitofrontal in a MCI-a group was thinner than a MCI-na group(p<0.05).The left par sorbitalis,right pars opercularis,right lateral orbitofrontal,right pars triangularis,right anterior cingulate gyrus in AD-a group was thinner than AD-na group(p<0.05).4.Correlation analysis:The volume of bilateral anterior cingulate gyrus measured by VBM technology has a significant negative correlation with AES-I each domain after correction of the total cranial volume(p<0.05).Cortical thickness was significantly negatively correlated with AES-I and its domains(p<0.05).Conclusion1.Apathy is a common psycho-behavioral symptom of Alzheimer's disease,the incidence of which gradually increases with the progress of AD,and the degree of indifference is significantly negatively correlated with cognitive function.Apathy should be valued by clinicians and regarded as AD for further study as the common manifestations of non-cognitive symptoms.2.The bilateral anterior cingulate gyrus,the right medial frontal gyrus,the right frontal insula and the right pars triangularis were associated with apathy,and the decreased volume of witch was correlated with indifference.The volume changes could be used as predictors of a MCI and become a risk factor for predicting its conversion to AD.