Grau-Olivares Marta, Bartrés-Faz David, Arboix Adrià, Soliva Joan-Carles, Rovira Mariana, Targa Cecilia, Junqué Carme
Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Barcelona, Spain.
Cerebrovasc Dis. 2007;23(5-6):353-61. doi: 10.1159/000099134. Epub 2007 Jan 30.
The aim of the present study was to investigate whether there were differences in neuroradiological features, including white-matter lesions and gray-matter volumes, between patients with lacunar infarction with and without mild cognitive impairment of the vascular type (MCI-V).
A total of 40 patients with lacunar infarction were studied within 1 month after stroke.
MCI-V was found in 22 patients, who in comparison with patients without cognitive impairment were significantly older and had fewer years of formal education. MRI subcortical hyperintensities especially in the basal ganglia (putamen and thalamus) were significantly more frequent in the MCI-V group. In the voxel-based morphometric study, patients with MCI-V showed more atrophy bilaterally in the middle temporal gyrus, right and left frontal and posterior bilateral occipitoparietal regions including the posterior cingulate as well as in the cerebellum. A region of interest analysis restricted to the parahippocampi and hippocampi showed further reduced bilateral parahippocampal gyrus and right hippocampus volume reductions in this group of patients. Finally, the amount of white-matter lesions among MCI-V showed negative correlations with gray-matter volume in frontal and temporal areas as well as with the thalamus and mesencephalon.
The present findings provide support for an anatomical substrate of the MCI entity in patients with lacunar infarction. Both gray- and white-matter changes seem to contribute to the cognitive impairment of such patients.
本研究旨在调查伴和不伴血管性轻度认知障碍（MCI-V）的腔隙性脑梗死患者在神经放射学特征（包括白质病变和灰质体积）方面是否存在差异。
共对40例腔隙性脑梗死患者在卒中后1个月内进行了研究。
22例患者被发现存在MCI-V，与无认知障碍的患者相比，他们年龄显著更大，接受正规教育的年限更少。MCI-V组中，MRI显示的皮质下高信号，尤其是基底节（壳核和丘脑）区域的高信号明显更常见。在基于体素的形态学研究中，MCI-V患者双侧颞中回、左右额叶以及包括后扣带回在内的双侧枕顶叶后部区域以及小脑出现更多萎缩。对海马旁回和海马进行的感兴趣区域分析显示，该组患者双侧海马旁回进一步缩小，右侧海马体积减小。最后，MCI-V患者的白质病变数量与额叶和颞叶区域的灰质体积以及丘脑和中脑的灰质体积呈负相关。
本研究结果为腔隙性脑梗死患者中MCI实体的解剖学基础提供了支持。灰质和白质的变化似乎都导致了此类患者的认知障碍。
