Capizzano A A, Ación L, Bekinschtein T, Furman M, Gomila H, Martínez A, Mizrahi R, Starkstein S E
MRI Unit, Fernández Hospital, Buenos Aires, Argentina.
J Neurol Neurosurg Psychiatry. 2004 Jun;75(6):822-7. doi: 10.1136/jnnp.2003.019273.
Methodological variability in the assessment of white matter hyperintensities (WMH) in dementia may explain inconsistent reports of its prevalence and impact on cognition. We used a method of brain MRI segmentation for quantifying both tissue and WMH volumes in Alzheimer's disease (AD) and examined the association between WMH and structural and cognitive variables.
A consecutive series of 81 patients meeting NINCDS-ADRDA criteria for probable AD was studied. Nineteen healthy volunteers of comparable age served as the control group. Patients had a complete neurological and neuropsychological evaluation, and a three dimensional MRI was obtained. Images were segmented into grey matter, white matter, and cerebrospinal fluid. WMH were edited on segmented images, and lobar assignments were based on Talairach coordinates.
Mild and moderate to severe AD patients had significantly more WMH than controls (p<0.05). WMH preferentially involved the frontal lobes (70%), were inversely correlated with grey matter cortical volume (R(2) = 0.23, p<0.001), and were significantly associated with vascular risk factors and with a worse performance on memory tasks.
Objective measurements of tissue volumes in AD demonstrated that WMH are significantly related to cortical atrophy and neuropsychological impairment.
痴呆症中白质高信号（WMH）评估的方法学差异可能解释了其患病率及对认知影响的报道不一致的情况。我们采用一种脑MRI分割方法来量化阿尔茨海默病（AD）中的组织和WMH体积，并研究WMH与结构及认知变量之间的关联。
对连续的81例符合NINCDS-ADRDA标准的可能AD患者进行研究。19名年龄相仿的健康志愿者作为对照组。患者接受了完整的神经学和神经心理学评估，并进行了三维MRI检查。图像被分割为灰质、白质和脑脊液。在分割图像上编辑WMH，并根据Talairach坐标进行脑叶定位。
轻度和中度至重度AD患者的WMH明显多于对照组（p<0.05）。WMH优先累及额叶（70%），与灰质皮质体积呈负相关（R(2)=0.23，p<0.001），并与血管危险因素及记忆任务表现较差显著相关。
AD中组织体积的客观测量表明，WMH与皮质萎缩和神经心理学损害显著相关。
