Функциональная связанность в височных областях головного мозга и конверсия в болезнь Альцгеймера при мягком когнитивном снижении амнестического типа

Обоснование: структурные и нейрохимические изменения височной доли и области височно-теменного стыка (В-ВТ) регистрируются не только при болезни Альцгеймера (БА), но и при мягком когнитивном снижении амнестического типа (аМКС). Исследований, сфокусированных на функциональных характеристиках указанных областей в свете процессов перехода к деменции, недостаточно. Цель исследования: поиск параметров функциональной связанности (ФС) в В-ВТ, отличающих пациентов с аМКС и последующей конверсией в БА от пациентов с аМКС в стабильном состоянии и лиц без когнитивного снижения. Пациенты, группа контроля и методы: пациенты с аМКС, которым по результатам катамнестического наблюдения был поставлен диагноз деменции при БА (конвертеры, n = 15), пациенты с аМКС и отсутствием клинически значимой динамики (n = 12) и здоровые люди без когнитивных расстройств (n = 29) обследованы методом функциональной магнитно-резонансной томографии покоя. Было проведено межгрупповое сравнение ФС между корковыми структурами внутри В-ВТ отдельно для каждого полушария (one-way ANCOVA; post hoc анализ с попарными сравнениями групп). Результаты: у конвертеров по сравнению с другими группами наблюдалась повышенная ФС между задними частями средней и нижней височных извилин левого полушария. ФС между указанными регионами обратно коррелировала с продуктивностью отсроченного воспроизведения слов (шкала MoCA) во всей выборке, однако данный результат не достигал статистической значимости (p = 0,055). Заключение: поскольку задние части средней и нижней височных извилин левого полушария важны для обеспечения слухоречевой памяти и хранения связанных со словом зрительных образов, соответственно, обнаруженная нейрофизиологическая особенность будущих конвертеров может быть признаком начавшегося патологического процесса и/или проявлением компенсаторных механизмов.

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