Knoops Arnoud Jan Gilbert, van der Graaf Yolanda, Appelman Auke Peter Adriaan, Mali Willem Petrus Theodorus Maria, Geerlings Mirjam Irene
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
J Cereb Blood Flow Metab. 2009 Oct;29(10):1727-33. doi: 10.1038/jcbfm.2009.91. Epub 2009 Jul 15.
It has been suggested that compared with other brain tissues, the hippocampus in particular is vulnerable to chronic hypoperfusion. We investigated whether total parenchymal cerebral blood flow (pCBF) was associated with hippocampal atrophy, and also whether this relationship was modified by white matter lesions (WMLs). In a cross-sectional analysis within the SMART-MR (Second Manifestations of ARTerial disease-magnetic resonance) study, which is a cohort study among patients with arterial disease, total CBF (tCBF) and hippocampal volume were assessed in 392 patients (mean age: 62+/-9 years, 84% men). Total CBF was expressed in per 100 mL brain volume for obtaining pCBF. Manual volumetric measurements of the hippocampus were carried out on a three-dimensional fast field-echo T1-weighted magnetic resonance imaging scan with isotropic voxels. Automated brain segmentation was used to quantify volumes of the WML and the total brain. A linear regression analysis showed that reduced pCBF was not associated with smaller hippocampal volume after adjustments were made for age and sex. The association attenuated further after additional adjustments were made for vascular risk factors, lacunar infarcts, and WMLs (beta=0.01 mL per s.d. decrease in pCBF; 95% confidence interval: -0.06 to 0.08). The association was not modified by WML (P-value for interaction term pCBF*WML=0.84). We found no evidence of the fact that lower parenchymal blood flow contributes to the neurodegeneration of the hippocampus in a population of patients with arterial disease.
有人提出，与其他脑组织相比，海马体尤其容易受到慢性灌注不足的影响。我们研究了脑实质总血流量（pCBF）是否与海马萎缩有关，以及这种关系是否会因白质病变（WMLs）而改变。在ARTerial疾病磁共振成像（SMART-MR）研究的横断面分析中，该研究是一项针对动脉疾病患者的队列研究，对392名患者（平均年龄：62±9岁，84%为男性）的总脑血流量（tCBF）和海马体积进行了评估。总脑血流量以每100 mL脑体积表示，以获得pCBF。在具有各向同性体素的三维快速场回波T1加权磁共振成像扫描上对海马进行手动体积测量。使用自动脑分割来量化WML和全脑的体积。线性回归分析表明，在对年龄和性别进行调整后，pCBF降低与较小的海马体积无关。在对血管危险因素、腔隙性梗死和WML进行进一步调整后，这种关联进一步减弱（β=每标准差pCBF降低0.01 mL；95%置信区间：-0.06至0.08）。WML未改变这种关联（交互项pCBF*WML的P值=0.84）。在动脉疾病患者群体中，我们没有发现脑实质血流量降低会导致海马神经退行性变的证据。
