Grool Anne M, van der Graaf Yolanda, Witkamp Theo D, Vincken Koen L, Mali Willem P T M, Geerlings Mirjam I
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
J Aging Res. 2011;2011:280630. doi: 10.4061/2011/280630. Epub 2011 Oct 16.
Objectives. Mechanisms influencing the course of physical and mental functioning after an atherosclerotic event are unclear. We examined effects of white matter lesion (WML) activity on changes in functioning in patients with symptomatic atherosclerotic disease. Methods. In 486 patients (58 ± 9 years) of the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, volumetric WML measurements on 1.5T MRI were performed at baseline and 3.9 ± 0.4 years followup. Functioning was assessed with the modified Short-Form 12 (SF-12) questionnaire. Associations of WML progression with changes in functioning were adjusted for age, sex, and vascular risk factors. Results. Physical functioning (baseline: 44, 10th-90th percentile 29-55) improved, whereas mental functioning (baseline: 51, 10th-90th percentile 32-60) declined during followup. WML progression (highest quartile versus rest) contributed to a stronger decline in mental functioning (B = -1.76, 95% CI -3.11 to -0.42), but did not influence changes in physical functioning. Conclusions. Progression of WML volume contributes to a decline in mental functioning in patients with symptomatic atherosclerotic disease.
目的。动脉粥样硬化事件后影响身心功能进程的机制尚不清楚。我们研究了白质病变（WML）活动对有症状动脉粥样硬化疾病患者功能变化的影响。方法。在动脉疾病二次表现-磁共振（SMART-MR）研究的486例患者（58±9岁）中，在基线和3.9±0.4年随访时进行了1.5T MRI的WML体积测量。使用改良的简短健康调查（SF-12）问卷评估功能。针对年龄、性别和血管危险因素对WML进展与功能变化之间的关联进行了校正。结果。在随访期间，身体功能（基线：44，第10-90百分位数29-55）有所改善，而心理功能（基线：51，第10-90百分位数32-60）下降。WML进展（最高四分位数与其余部分相比）导致心理功能下降更明显（B=-1.76，95%CI -3.11至-0.42），但不影响身体功能的变化。结论。WML体积的进展导致有症状动脉粥样硬化疾病患者心理功能下降。
