Luchsinger J A, Brickman A M, Reitz C, Cho S J, Schupf N, Manly J J, Tang M X, Small S A, Mayeux R, DeCarli C, Brown T R
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
Neurology. 2009 Aug 11;73(6):450-6. doi: 10.1212/WNL.0b013e3181b1636a.
Cerebrovascular disease (CVD) may contribute to mild cognitive impairment (MCI). We sought to determine the relation of white matter hyperintensity (WMH) volume and infarcts in brain MRI to MCI in a community-based sample.
A total of 679 elderly persons without dementia underwent brain MRI. WMH and infarcts were quantified using research methods. WMH was adjusted for total cranial volume. The Petersen criteria were used to define MCI. MCI was further subclassified into amnestic and non-amnestic. We used logistic regression to relate WMH and infarcts to prevalent MCI.
WMH were associated with amnestic MCI (odds ratio [OR] = 1.9; 95% confidence interval [CI] 1.1, 3.4) but not non-amnestic MCI (OR = 1.2; 95% CI 0.4, 1.6) after adjusting for age, gender, ethnic group, education, and APOE-epsilon4. Infarcts were more strongly associated with non-amnestic MCI (OR = 2.7; 95% CI 1.5, 4.8) than amnestic MCI (OR = 1.4; 95% CI 0.9, 2.3). In secondary analyses using continuous cognitive scores as outcomes, WMH, but not infarcts, were related to memory, while infarcts were more strongly related with non-amnestic domains.
White matter hyperintensity (WMH) is more strongly related to amnestic mild cognitive impairment (MCI). Infarcts are more strongly related to non-amnestic MCI. The nature of WMH in amnestic MCI requires further study.
脑血管疾病（CVD）可能导致轻度认知障碍（MCI）。我们试图在一个基于社区的样本中确定脑磁共振成像（MRI）中的白质高信号（WMH）体积和梗死灶与MCI之间的关系。
共有679名无痴呆的老年人接受了脑部MRI检查。使用研究方法对WMH和梗死灶进行量化。WMH根据总颅腔体积进行校正。采用彼得森标准定义MCI。MCI进一步分为遗忘型和非遗忘型。我们使用逻辑回归分析WMH和梗死灶与现患MCI之间的关系。
在校正年龄、性别、种族、教育程度和APOE-ε4后，WMH与遗忘型MCI相关（优势比[OR]=1.9；95%置信区间[CI]1.1,3.4），但与非遗忘型MCI无关（OR=1.2；95%CI0.4,1.6）。梗死灶与非遗忘型MCI的相关性（OR=2.7；95%CI1.5,4.8）比与遗忘型MCI的相关性更强（OR=1.4；95%CI0.9,2.3）。在以连续认知分数为结局的二次分析中，WMH而非梗死灶与记忆相关，而梗死灶与非遗忘领域的相关性更强。
白质高信号（WMH）与遗忘型轻度认知障碍（MCI）的关系更为密切。梗死灶与非遗忘型MCI的关系更为密切。遗忘型MCI中WMH的性质需要进一步研究。
