Miranda B, Madureira S, Verdelho A, Ferro J, Pantoni L, Salvadori E, Chabriat H, Erkinjuntti T, Fazekas F, Hennerici M, O'Brien J, Scheltens P, Visser M C, Wahlund L-O, Waldemar G, Wallin A, Inzitarion D
Serviço de Neurologia, Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal.
J Neurol Neurosurg Psychiatry. 2008 Aug;79(8):869-73. doi: 10.1136/jnnp.2007.131078. Epub 2007 Dec 12.
To determine whether self-perceived memory impairment is associated with the severity of white matter changes (WMC) and is related to cognitive impairment.
Data were drawn from the multinational Leukoaraiosis and Disability Study (LADIS), which investigates the impact of WMC on global functioning. WMC severity was rated using the Fazekas scale. Medial temporal lobe atrophy (MTA) was scored visually and mean values were calculated. The neuropsychological battery consisted of the Mini-Mental State Examination, a modified version of the VADAS-Cog, Trail making and Stroop tests. A question about self-perceived memory impairment was used as a measure for presence of memory complaints. Cognitive performance was analysed test-by-test and in three main domains: memory, executive functions and speed/motor control. The Geriatric Depression Scale (GDS) was used as a measure of depressive symptoms.
Six hundred and thirty-eight subjects were included in this study. No association was found between memory complaints and the severity of WMC. Subjects with memory complaints (n = 399) had a higher GDS score [t((637)) = -7.15; p<0.02] and performed worse on almost all cognitive tests and on the three cognitive domains. Multiple linear regression showed that the worse performance on the memory domain was associated with memory complaints independently of depressive symptoms, WMC severity and MTA (R(2) = 0.183; F = 17.09, beta = -0.126; p<0.05).
In a sample of non-disabled elderly subjects with WMC, self-perceived memory impairment is significantly associated with objective memory impairment independently of the WMC severity, depressive symptoms and MTA.
确定自我感知的记忆障碍是否与白质改变（WMC）的严重程度相关，以及是否与认知障碍有关。
数据来自多国白质疏松症与残疾研究（LADIS），该研究调查了WMC对整体功能的影响。使用 Fazekas 量表对WMC严重程度进行评分。通过视觉对内侧颞叶萎缩（MTA）进行评分并计算平均值。神经心理测试组包括简易精神状态检查表、VADAS-Cog 修改版、连线测验和 Stroop 测试。使用一个关于自我感知记忆障碍的问题作为记忆主诉存在与否的衡量标准。逐一对认知表现进行分析，并在三个主要领域进行分析：记忆、执行功能和速度/运动控制。使用老年抑郁量表（GDS）作为抑郁症状的衡量标准。
本研究纳入了 638 名受试者。未发现记忆主诉与WMC严重程度之间存在关联。有记忆主诉的受试者（n = 399）的 GDS 得分更高[t((637)) = -7.15；p<0.02]，并且在几乎所有认知测试和三个认知领域的表现都更差。多元线性回归显示，记忆领域表现较差与记忆主诉相关，独立于抑郁症状、WMC严重程度和MTA（R(2) = 0.183；F = 17.09，β = -0.126；p<0.05）。
在患有WMC的非残疾老年受试者样本中，自我感知的记忆障碍与客观记忆障碍显著相关，独立于WMC严重程度、抑郁症状和MTA。
