主觀記憶障礙與大腦皮質厚度關聯

An Association Study of Subjective Memory Impairment and Cerebral Cortical Thickness

李知諭(Chih-Yu Lee)

指導教授 ： 徐建業

臺北醫學大學/醫學科技學院/醫學資訊研究所/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00083

摘要

隨著醫療科技的進步，大幅提升了人類的平均壽命，臺灣於1993年已符合聯合國所定義65歲以上老年人口超過7%的高齡化國家。近年來人口快速老化，根據內政部截至2010年統計，台灣地區65歲以上的人口數已高達248萬人，佔全台灣人口總數的10.7% (內政部統計處 重要參考指標)。高齡化社會需要面臨許多慢性疾病的議題，失智症就是其中一項需要重視的高齡化疾病。
輕度認知功能障礙(mild cognitive impairment, MCI)的患者，有10%-15%會發展成為失智症，被視為是早期失智症的高危險群。故本研究以尚未罹患輕度認知功能障礙而出現主觀性記憶障礙(Subjective Memory Impairment, SMI )的患者與健康族群為研究對象，研究對象均施測「極早期失智症量表」(Ascertain Dementia 8, AD-8)，並以量表得分作為分組工具，將其區分為主觀記憶障礙與健康兩群體。利用Freesurfer軟體將頭部核磁共振影像(MRI)進行影像處理，針對在腦部負責思考、記憶與學習之大腦皮質進行厚度上計算、分析與比較。在沒有作年齡校正的結果下發現於雙側下顳葉、雙側上頂葉、右側島回(insula)主觀記憶障礙組較健康組有皮質減少。排除掉受年齡影響的皮質區域後於發現在主觀記憶障礙組之皮質厚度較健康組於雙側下顳葉、雙側上頂葉、雙側上顳葉、左側中央溝旁、左側外枕葉、左側額葉中下方、左側上額葉、右側島回有減少的現象。從結果除了得知主觀記憶障礙與局部大腦皮質厚度的關聯外，年齡也是影響結果的一項重要的因素。

關鍵字

輕度認知功能障礙 ； 主觀記憶障礙 ； 極早期失智症量表 ； 大腦皮質厚度

並列摘要

With the advancements of medical technology, the average human life span has been enhanced significantly. According to the definition of United Nations, Taiwan is already an aging society which the population of 65 and older is more than 7% of the country. Recently, population is aging rapidly in Taiwan. With the latest statistics by Ministry of the Interior in 2009, the population of 65 years and older in Taiwan has reached 2.4 million, which is 10.6% of the total population [1]. Aging society is going to confront with many chronic disease issues, and dementia is the one has to be focused on.
About 10% -15% of mild cognitive impairment (MCI) patients will develop into dementia, and they are considered as high-risk of early dementia. Therefore, the study focused on those who have subjective memory impairment (SMI) but not yet suffer from mild cognitive impairment. I used the subjective test score of Ascertain Dementia 8 (AD-8) as assessment, and divided the subjects into subjective memory impairment (SMI) and normal two groups. Using the Freesurfer software, we processed the images of their head Magnetic Resonance Imaging (MRI), then calculate, analyze and compare the thickness of the cerebral cortex in the brain responsible for thinking, memory and learning. The results shown that, before age-adjusted, SMI group had reduced cerebral cortical thickness of the bilateral inferior temporal, the bilateral superior parietal and the right insula compared to the normal group. After age-adjusted, we found that, SMI group had reduced cerebral cortical thickness of the bilateral inferior temporal, the bilateral superior parietal, the bilateral superior temporal, the left paracentral, the left lateral occipital, the left rostral middle frontal, the left superior frontal, the right insula compared to the normal group. Besides the association of subjective memory impairment and partial thickness of the cerebral cortex, the age is an important factor affecting the results.

並列關鍵字

Mild Cognitive Impairment ； Subjective Memory Impairment ； Ascertain Dementia 8 ； Cerebral Cortical Thickness

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