Department of Neurology and Alzheimer Center, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. s.staekenborg @ vumc.nl
Dement Geriatr Cogn Disord. 2010;29(4):301-8. doi: 10.1159/000254791. Epub 2010 Apr 14.
To determine the frequency of neurological signs in a memory clinic population and to explore their associations with white matter hyperintensity (WMH).
We included patients with Alzheimer disease (AD; n = 210), vascular dementia (VaD; n = 34), mild cognitive impairment (MCI; n = 86) and subjective complaints (n = 153). The presence of extrapyramidal and unilateral signs was assessed from medical charts. On MRI, WMH volumes were extracted automatically.
Extrapyramidal signs were found in 10% and unilateral signs in 12% of the patients. Age- and sex-adjusted extrapyramidal signs occurred more often in VaD compared to patients with subjective complaints. Unilateral signs were more prevalent in all groups compared to patients with subjective complaints. Two-way analysis of variance (ANOVA) with WMH as the dependent variable showed a main effect of diagnosis (p < 0.001), but not of extrapyramidal signs (p = 0.62). In contrast, 2-way ANOVA showed main effects of diagnosis (p < 0.001) and unilateral signs (p = 0.001). Furthermore, there was an interaction between these factors (p = 0.04); if unilateral signs were present, patients with subjective complaints and VaD showed more WMH, whereas there was no relation in AD and MCI.
Extrapyramidal and unilateral signs are common in memory clinic patients, but are only modestly related to WMH.
确定记忆诊所人群中神经体征的频率，并探讨其与脑白质高信号（WMH）的关系。
我们纳入了阿尔茨海默病（AD；n=210）、血管性痴呆（VaD；n=34）、轻度认知障碍（MCI；n=86）和主观抱怨（n=153）患者。从病历中评估了锥体外系和单侧体征的存在。在 MRI 上，自动提取 WMH 体积。
10%的患者存在锥体外系体征，12%的患者存在单侧体征。与有主观抱怨的患者相比，年龄和性别调整后的锥体外系体征在 VaD 中更为常见。与有主观抱怨的患者相比，所有组中单侧体征更为常见。以 WMH 为因变量的双因素方差分析（ANOVA）显示诊断有主要影响（p<0.001），但锥体外系体征无主要影响（p=0.62）。相反，2 因素 ANOVA 显示诊断（p<0.001）和单侧体征（p=0.001）有主要影响。此外，这些因素之间存在交互作用（p=0.04）；如果存在单侧体征，有主观抱怨和 VaD 的患者有更多的 WMH，而在 AD 和 MCI 中则没有关系。
锥体外系和单侧体征在记忆诊所患者中很常见，但与 WMH 仅有适度的关系。
