Ishii H, Meguro K, Yamaguchi S, Ishikawa H, Yamadori A
Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Eur J Neurol. 2007 Jun;14(6):609-16. doi: 10.1111/j.1468-1331.2007.01781.x.
Prevalence, magnetic resonance imaging (MRI) findings, cognitive function and depression are four major aspects of vascular cognitive impairment no dementia (vascular CIND). We performed a community-based study to examine these using 497 community-residents aged 65 years or older. Vascular CIND was defined as a clinical dementia rating (CDR) 0.5 with cerebrovascular disease. Several neuropsychological tests were performed, including MMSE, Geriatric Depression Scale (GDS), and Trail Making Test (TMT). Cerebrovascular disease and white matter lesions were visually assessed using MRI. Prevalence of vascular CIND, localization of cerebrovascular disease, and the relationships amongst MRI findings, white matter lesions, cognitive impairment and depression were analyzed. The prevalence of vascular CIND was 8.5% amongst the total population, corresponding to the rate being 37.2% amongst the CDR 0.5 participants. Compared with the CDR 0, the CDR 0.5 group had more subjects with strategic cerebrovascular disease in the thalamus, etc. No effects of cerebrovascular disease on MMSE and GDS scores were found, but the CDR 0.5/strategic cerebrovascular disease group showed impaired TMT-B scores. In the CDR 0 group, only anterior periventricular hyperintensity was associated with TMT-A score independent of cerebrovascular disease. A vascular CIND population was identified, and executive dysfunction in this population is probably based on an impaired fronto-subcortical circuit.
患病率、磁共振成像(MRI)表现、认知功能和抑郁是血管性轻度认知障碍(vascular CIND)的四个主要方面。我们进行了一项基于社区的研究,以65岁及以上的497名社区居民为对象,对这些方面进行了研究。血管性轻度认知障碍被定义为临床痴呆评定量表(CDR)评分为0.5且伴有脑血管疾病。进行了多项神经心理学测试,包括简易精神状态检查表(MMSE)、老年抑郁量表(GDS)和连线测验(TMT)。使用MRI对脑血管疾病和白质病变进行了视觉评估。分析了血管性轻度认知障碍的患病率、脑血管疾病的定位,以及MRI表现、白质病变、认知障碍和抑郁之间的关系。血管性轻度认知障碍在总人口中的患病率为8.5%,在CDR评分为0.5的参与者中这一比例为37.2%。与CDR评分为0的组相比,CDR评分为0.5的组在丘脑等部位有更多患有战略性脑血管疾病的受试者。未发现脑血管疾病对MMSE和GDS评分有影响,但CDR评分为0.5/战略性脑血管疾病组的TMT-B评分受损。在CDR评分为0的组中,仅脑室旁白质高信号与独立于脑血管疾病的TMT-A评分相关。确定了一个血管性轻度认知障碍人群,该人群的执行功能障碍可能基于额叶-皮质下回路受损。