Department of Radiology, University Medical Center Utrecht, The Netherlands.
Dement Geriatr Cogn Disord. 2010;29(3):240-7. doi: 10.1159/000289813. Epub 2010 Apr 6.
BACKGROUND/AIMS: It has been hypothesized that cerebral hypoperfusion may contribute to cognitive deterioration. Patients with white matter lesions (WML) may be more vulnerable to a decrease in cerebral blood flow (CBF) due to an impaired autoregulation. We investigated the association between CBF and cognitive performance and whether WML modified this relation.
Within the SMART-MR study, a cohort study among patients with manifest arterial disease, cross-sectional analyses were performed in 472 patients (mean age 57 +/- 10 years, 77% male). Total CBF was measured with magnetic resonance angiography in the internal carotid arteries and basilar artery, and was expressed per 100 ml brain volume. Neuropsychological tests assessing executive functioning and memory were performed and composite scores were calculated. We used linear regression analyses, adjusted for age, sex, education and intelligence, to investigate the association between CBF and cognitive performance.
We found that WML modified the association between CBF and executive functioning (p for interaction <0.001); the association between lower CBF and worse performance on executive functioning became stronger and significant with increasing volumes of WML. Lower CBF was not associated with worse memory.
Our results suggest that a combination of lower CBF and WML may impair executive functioning but not memory.
背景/目的：脑灌注不足可能导致认知功能恶化，这一假说已被提出。由于自动调节受损，白质病变（WML）患者的脑血流（CBF）下降可能更为敏感。我们研究了 CBF 与认知表现之间的相关性，以及 WML 是否改变了这种关系。
在 SMART-MR 研究中，我们对表现为动脉疾病的患者进行了队列研究，对 472 名患者（平均年龄 57 +/- 10 岁，77%为男性）进行了横断面分析。使用磁共振血管造影术在颈内动脉和基底动脉中测量总 CBF，并以每 100 毫升脑体积表示。进行了评估执行功能和记忆的神经心理学测试，并计算了综合评分。我们使用线性回归分析，调整了年龄、性别、教育和智力，以研究 CBF 与认知表现之间的关系。
我们发现 WML 改变了 CBF 与执行功能之间的关联（交互作用的 p 值 <0.001）；随着 WML 体积的增加，较低 CBF 与执行功能下降之间的关联变得更强且具有统计学意义。较低的 CBF 与记忆下降无关。
我们的结果表明，较低的 CBF 与 WML 的结合可能会损害执行功能，但不会损害记忆。
