Garde E, Mortensen E L, Krabbe K, Rostrup E, Larsson H B
Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital, Hvidovre.
Lancet. 2000 Aug 19;356(9230):628-34. doi: 10.1016/S0140-6736(00)02604-0.
White-matter hyperintensities are commonly found on magnetic resonance imaging (MRI) of elderly people with or without dementia. Studies of the relation between severity of white-matter hyperintensities and cognitive impairment have had conflicting results. We undertook a longitudinal study of age-related decline in intellectual function and MRI at age 80 years.
From a cohort of 698 people born in 1914 and living in seven municipalities in Denmark, 68 healthy non-demented individuals had been tested with the Wechsler adult intelligence scale (WAIS) at ages 50, 60, and 70, and they agreed to further WAIS testing at age 80, and cerebral MRI at age 80-82 (mean age 82.3 years). We scored separately the numbers of periventricular and deep white-matter hyperintensities.
Scores for periventricular hyperintensities in this sample included all possible degrees of severity, but no participant scored more than 75% of maximum for deep white-matter hyperintensities. Neither type was related to the WAIS IQs of the 80-year assessment, but both were significantly associated with decline in performance IQ from age 50 to age 80 years (bivariate correlation coefficients 0.32, p=0.0087, and 0.28, p=0.0227, respectively). An analysis based on two WAIS subtests showed that the association between white-matter hyperintensities and cognitive impairment was significant only for cognitive decline in the decade 70-80 years.
Both periventricular and deep white-matter hyperintensities are related to decline in intelligence but, in healthy octogenarians, the cumulative effect of these features alone explains only a small part of the large differences among individuals in age-related decline in intelligence. Interpretation of the presence and severity of white-matter hyperintensities in a diagnostic context must be done cautiously.
在患有或未患痴呆症的老年人的磁共振成像（MRI）中，白质高信号较为常见。关于白质高信号严重程度与认知障碍之间关系的研究结果相互矛盾。我们对80岁时智力功能与MRI的年龄相关性下降进行了一项纵向研究。
从丹麦七个城市出生于1914年的698人队列中，68名健康非痴呆个体在50岁、60岁和70岁时接受了韦氏成人智力量表（WAIS）测试，他们同意在80岁时进一步接受WAIS测试，并在80 - 82岁（平均年龄82.3岁）时进行脑部MRI检查。我们分别对脑室周围和深部白质高信号的数量进行评分。
该样本中脑室周围高信号的评分涵盖了所有可能的严重程度，但没有参与者的深部白质高信号评分超过最大值的75%。两种类型的高信号均与80岁评估时的WAIS智商无关，但两者均与50岁至80岁时操作智商的下降显著相关（双变量相关系数分别为0.32，p = 0.0087和0.28，p = 0.0227）。基于两个WAIS子测试的分析表明，白质高信号与认知障碍之间的关联仅在70 - 80岁这十年的认知下降中显著。
脑室周围和深部白质高信号均与智力下降有关，但在健康的八十多岁老人中，这些特征的累积效应仅解释了个体在智力年龄相关性下降方面巨大差异的一小部分。在诊断背景下对白质高信号的存在和严重程度进行解读时必须谨慎。
