认知障碍患者的脑结构与脑血管风险：上海社区脑健康计划——试点阶段
Brain structure and cerebrovascular risk in cognitively impaired patients: Shanghai Community Brain Health Initiative-pilot phase.
作者信息
He Jing, Iosif Ana-Maria, Lee Dong Young, Martinez Oliver, Chu Shuguang, Carmichael Owen, Mortimer James A, Zhao Qianhua, Ding Ding, Guo Qihao, Galasko Douglas, Salmon David P, Dai Qi, Wu Yougui, Petersen Ronald C, Hong Zhen, Borenstein Amy R, DeCarli Charles
机构信息
Department of Neurology, University of California at Davis, Sacramento, CA 95817, USA.
出版信息
Arch Neurol. 2010 Oct;67(10):1231-7. doi: 10.1001/archneurol.2010.230.
OBJECTIVE
To investigate the associations among brain morphologic changes as seen on magnetic resonance imaging (MRI), cerebrovascular risk (CVR), and clinical diagnosis and cognition in elderly patients with mild cognitive impairment and dementia living in urban Shanghai.
DESIGN
Cross-sectional study performed from May 1, 2007, to November 31, 2008.
SETTING
Memory Disorders Clinic of the Huashan Hospital and the Shanghai community.
PARTICIPANTS
Ninety-six older people: 32 with normal cognition (NC), 30 with amnestic mild cognitive impairment (aMCI), and 34 with dementia.
MAIN OUTCOME MEASURES
For each patient, we administered a neurologic and physical examination, neuropsychological evaluation, and brain MRI and genotyped the apolipoprotein E-ε4 (APOE-ε4) gene. The volumes determined by MRI were assessed using a semiautomatic method.
RESULTS
Brain volume was significantly smaller in the dementia patients compared with the NC (P < .001) and aMCI patients (P = .04). Hippocampal volume (HV) was lower and white matter hyperintensity (WMH) volume was higher in those with aMCI (HV: P = .03; WMH volume: P = .04) and dementia (HV: P < .001; WMH volume: P = .002) compared with NC participants. The presence of APOE-ε4 was significantly associated with reduced HV (P = .02). Systolic blood pressure was positively associated with CVR score (P = .04); diastolic blood pressure (P = .02) and CVR score (P = .04) were positively associated with WMH volume. The WMH volume (P = .03) and CVR score (P = .03) were higher among dementia patients compared with NC participants.
CONCLUSIONS
Brain structure changes seen on MRI were significantly associated with clinical diagnosis. In addition, blood pressure was highly associated with CVR score and WMH volume. These results suggest that MRI is a valuable measure of brain injury in a Chinese cohort and can serve to assess the effects of various degenerative and cerebrovascular diseases.
目的
研究居住在上海市区的轻度认知障碍和痴呆老年患者的磁共振成像（MRI）显示的脑形态学变化、脑血管风险（CVR）以及临床诊断和认知之间的关联。
设计
2007年5月1日至2008年11月31日进行的横断面研究。
地点
华山医院记忆障碍门诊及上海社区。
参与者
96名老年人，其中32名认知正常（NC），30名遗忘型轻度认知障碍（aMCI），34名痴呆患者。
主要观察指标
对每位患者进行神经和体格检查、神经心理学评估及脑部MRI检查，并对载脂蛋白E-ε4（APOE-ε4）基因进行基因分型。MRI测定的体积采用半自动方法评估。
结果
与NC组（P <.001）和aMCI组（P =.04）相比，痴呆患者的脑体积明显更小。与NC参与者相比，aMCI组（海马体积：P =.03；白质高信号体积：P =.04）和痴呆组（海马体积：P <.001；白质高信号体积：P =.002）的海马体积（HV）更低，白质高信号（WMH）体积更高。APOE-ε4的存在与海马体积减小显著相关（P =.02）。收缩压与CVR评分呈正相关（P =.04）；舒张压（P =.02）和CVR评分（P =.04）与白质高信号体积呈正相关。与NC参与者相比，痴呆患者的白质高信号体积（P =.03）和CVR评分（P =.03）更高。
结论
MRI显示的脑结构变化与临床诊断显著相关。此外，血压与CVR评分和白质高信号体积高度相关。这些结果表明，MRI是中国人群脑损伤的一项有价值的测量指标，可用于评估各种退行性和脑血管疾病的影响。
Zotero 插件