Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
J Neuroimaging. 2010 Jan;20(1):37-45. doi: 10.1111/j.1552-6569.2008.00293.x. Epub 2009 Feb 10.
Amnestic mild cognitive impairment (MCI) is known to be a preclinical stage of Alzheimer's disease (AD). Similarly, MCI associated with small-vessel disease (svMCI), might be a forme froste of subcortical vascular dementia (SVaD). Patterns of cortical thinning in addition to the ischemia rating on MRI may further elucidate the clinical characteristics and pathogenesis of SVaD and svMCI. We tried to determine if svMCI differs from SVaD in the distribution of cortical atrophy, which may help understand the hierarchy between svMCI and SVaD and possibly also how svMCI evolves into SVaD.
Twenty patients with SVaD, 34 patients with svMCI, 115 patients with AD, and 96 individuals with normal-cognition (NC) were imaged with magnetic resonance imaging (MRI) including 3-dimensional volumetric images for cortical thickness analysis across the entire brain.
Compared to NC, svMCI patients showed cortical thinning in inferior frontal and orbitofrontal gyri, anterior cingulate, insula, superior temporal gyrus, and lingual gyrus, while cortical thinning in SVaD patients involved all these areas plus dorsolateral prefrontal and temporal cortices.
Our findings suggest the presence of hierarchy between svMCI and SVaD, and that the cognitive decline from svMCI to SVaD is associated with lesions in dorsolateral prefrontal and temporal cortices.
遗忘型轻度认知障碍（MCI）是阿尔茨海默病（AD）的临床前阶段。同样，与小血管疾病（svMCI）相关的 MCI 可能是皮质下血管性痴呆（SVaD）的早期表现。MRI 上除了缺血评分外，皮质变薄的模式可能进一步阐明 SVaD 和 svMCI 的临床特征和发病机制。我们试图确定 svMCI 在皮质萎缩分布上是否与 SVaD 不同，这可能有助于理解 svMCI 和 SVaD 之间的层次关系，以及 svMCI 如何演变为 SVaD。
对 20 例 SVaD 患者、34 例 svMCI 患者、115 例 AD 患者和 96 例认知正常（NC）个体进行磁共振成像（MRI）检查，包括全脑皮质厚度分析的 3 维容积图像。
与 NC 相比，svMCI 患者的额下回和眶额回、前扣带回、岛叶、颞上回和舌回出现皮质变薄，而 SVaD 患者的皮质变薄累及所有这些区域以及额中回和颞叶皮质。
我们的研究结果表明，svMCI 和 SVaD 之间存在层次关系，svMCI 向 SVaD 的认知下降与额上回和颞叶皮质的病变有关。
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