血管性认知障碍但无痴呆的神经心理学特征及区域性脑血流。
The neuropsychological characteristics and regional cerebral blood flow of vascular cognitive impairment-no dementia.
机构信息
Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Fudan University, Shanghai, China.
出版信息
Int J Geriatr Psychiatry. 2010 Nov;25(11):1168-76. doi: 10.1002/gps.2458.
OBJECTIVE
To investigate the neuropsychological characteristics of VCI-ND and to analyze the relationship between deficit pattern and regional cerebral blood flow (rCBF) in various VCI-ND subtypes defined by cognitive features.
METHODS
69 subjects diagnosed with VCI-ND were recruited, then further classified into four subtypes: amnestic VCI-ND with single memory impairment (subtype I, n = 19), amnestic VCI-ND with multi-domain impairment (subtype II, n = 27), non-amnestic VCI-ND with single domain impairment (subtype III, n = 16), and non-amnestic VCI-ND with multi-domain impairment (subtype IV, n = 7) according to their cognitive profile. Xenon-CT scan was administered to 31 VCI-ND patients (11 of subtype I, 12 of subtype II and 8 of subtype III) and 10 normal controls (NC) to evaluate rCBF.
RESULTS
The rate of different cognitive domains impairment in VCI-ND group ranged from 17 to 66%, lowest in clock drawing test and highest in time of modified version of trails making test A and maze tracing compared with NC, significant reduced rCBF was found in bilateral temporal lobe and thalamus, left periventricular white matter and caudate of subtype I, and in left temporal lobe and lenticular nucleus, bilateral periventricular white matter, white matter adjacent to left posterior horn of lateral ventricular and right caudate of subtype III, while significant reduced rCBF of subtype II was found in left subfrontal white matter, bilateral subtemporoparietal white matter, right lenticular nucleus, and in both regions of subtype I and III.
CONCLUSIONS
The manifestation of rCBF in VCI-ND subtypes was consistent with performance of neuropsychological assessment.
目的
研究 VCIND 的神经心理学特征，并分析根据认知特征定义的各种 VCIND 亚型中缺陷模式与局部脑血流(rCBF)之间的关系。
方法
共纳入 69 例 VCIND 患者，进一步根据认知特征分为 4 个亚型：单纯记忆损害的遗忘型 VCIND（亚型 I，n = 19）、多领域损害的遗忘型 VCIND（亚型 II，n = 27）、单领域损害的非遗忘型 VCIND（亚型 III，n = 16）和多领域损害的非遗忘型 VCIND（亚型 IV，n = 7）。对 31 例 VCIND 患者（I 型 11 例、II 型 12 例、III 型 8 例）和 10 例正常对照（NC）进行氙 CT 扫描，以评估 rCBF。
结果
VCIND 组不同认知领域损害的发生率为 17%至 66%，以画钟试验最低，改良 Trail 制作试验 A 和迷宫追踪试验时间最高，与 NC 相比，I 型患者双侧颞叶和丘脑、左侧脑室周围白质和尾状核 rCBF 明显降低，III 型患者左侧颞叶和豆状核、双侧脑室周围白质、左外侧脑室后角邻近白质和右侧尾状核 rCBF 明显降低，而 II 型患者左侧额下白质、双侧颞顶叶白质、右侧豆状核和 I、III 型双侧区域 rCBF 明显降低。
结论
VCIND 亚型的 rCBF 表现与神经心理学评估结果一致。
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