Department of Neurology, Kyung Hee Medical Center, School of Medicine Kyung Hee University, 1 Hoegi-dong, Dongdaemoon-ku, Seoul 130-702, Republic of Korea.
J Clin Neurosci. 2011 Aug;18(8):1101-6. doi: 10.1016/j.jocn.2011.01.008. Epub 2011 Jul 2.
Few studies have examined white matter hyperintensities (WMH) along the cognitive continuum between single-domain amnestic mild cognitive impairment (sd-aMCI) and Alzheimer's disease (AD). The aims of our study were to explore relationships between the extent and location of WMH and disease severity along the cognitive continuum and to determine whether differences in the distribution of WMH could be predictive of specific patterns of cognitive impairment. We compared cognitive function, vascular risk factors, and regional (frontal lobe, parieto-occipital [PO] lobe, temporal lobe, periventricular [PV] white matter and deep white matter) WMH volume in 37 patients with mild AD, 23 patients with sd-aMCI, and 24 age-matched and education-matched normal controls. A quantitative volumetric method was applied to measure WMH burden. Total and regional WMH burdens, except for those in the temporal lobe, were significantly correlated with age (p<0.01). We found a trend toward increasing WMH volume with disease severity, higher in AD than in sd-aMCI and lowest in the controls. Total WMH volume was associated with the global cognitive test score. In multiple linear regression analysis, PV WMH volume, but not deep WMH volume, strongly predicted performances on the Controlled Oral Word Association test and the Color Word Stroop test after adjusting for important demographic variables. Only PO WMH volume was a significant predictor of a cognitive test score when frontal and temporal WMH volumes were simultaneously entered into the regression model. The extent and distribution of WMH, especially in the PV and PO regions, were associated with disease severity and reduced cognition.
很少有研究探讨过在单一领域遗忘型轻度认知障碍 (sd-aMCI) 和阿尔茨海默病 (AD) 之间的认知连续体中脑白质高信号 (WMH)。我们研究的目的是探讨 WMH 的程度和位置与认知连续体中疾病严重程度之间的关系，并确定 WMH 分布的差异是否可以预测特定类型的认知障碍。我们比较了 37 例轻度 AD 患者、23 例 sd-aMCI 患者和 24 名年龄和教育程度匹配的正常对照者的认知功能、血管危险因素以及局部（额叶、顶枕叶 [PO] 叶、颞叶、脑室周围 [PV] 白质和深部白质）WMH 体积。采用定量体积法测量 WMH 负担。除颞叶外，总 WMH 负担和各区域 WMH 负担均与年龄显著相关（p<0.01）。我们发现随着疾病严重程度的增加，WMH 体积呈上升趋势，AD 患者的 WMH 体积高于 sd-aMCI 患者，而正常对照组的 WMH 体积最低。总 WMH 体积与全球认知测试评分相关。在多元线性回归分析中，在调整重要人口统计学变量后，PV WMH 体积而非深部 WMH 体积与受控口头词语联想测试和颜色词语干扰测试的表现强烈相关。只有当同时将额叶和颞叶 WMH 体积纳入回归模型时，PO WMH 体积才是认知测试评分的显著预测因子。WMH 的程度和分布，尤其是在 PV 和 PO 区域，与疾病严重程度和认知能力下降有关。
