Lane Elizabeth M, Paul Robert H, Moser David J, Fletcher Thomas D, Cohen Ronald A
1Department of Psychology, University of Missouri - Saint Louis, Saint Louis, Missouri.
2Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa.
J Int Neuropsychol Soc. 2011 May;17(3):531-6. doi: 10.1017/S1355617711000324.
Subcortical hyperintensities (SH) on neuroimaging are a prominent feature of vascular dementia (VaD) and SH severity correlates with cognitive impairment in this population. Previous studies demonstrated that SH burden accounts for a degree of the cognitive burden among VaD patients, although it remains unclear if individual factors such as cognitive reserve influence cognitive status in VaD. To address this issue, we examined 36 individuals diagnosed with probable VaD (age = 77.56; education = 12). All individuals underwent MMSE evaluations and MRI brain scans. We predicted that individuals with higher educational attainment would exhibit less cognitive difficulty despite similar levels of SH volume, compared to individuals with less educational attainment. A regression analysis revealed that greater SH volume was associated with lower scores on the MMSE. Additionally, education moderated the relationship between SH volume and MMSE score, demonstrating that individuals with higher education had higher scores on the MMSE despite similar degrees of SH burden. These results suggest that educational attainment buffers the deleterious effects of SH burden on cognitive status among VaD patients.
神经影像学上的皮质下高信号（SH）是血管性痴呆（VaD）的一个显著特征，并且SH的严重程度与该人群的认知障碍相关。先前的研究表明，SH负担在VaD患者的认知负担中占一定程度，尽管尚不清楚诸如认知储备等个体因素是否会影响VaD患者的认知状态。为了解决这个问题，我们对36名被诊断为可能患有VaD的个体进行了研究（年龄=77.56；受教育年限=12）。所有个体均接受了简易精神状态检查表（MMSE）评估和脑部磁共振成像（MRI）扫描。我们预测，与受教育程度较低的个体相比，受教育程度较高的个体尽管SH体积水平相似，但认知困难会更少。回归分析显示，更大的SH体积与MMSE得分较低相关。此外，受教育程度调节了SH体积与MMSE得分之间的关系，表明尽管SH负担程度相似，但受教育程度较高的个体在MMSE上得分更高。这些结果表明，受教育程度缓冲了SH负担对VaD患者认知状态的有害影响。
