[皮质下缺血性脑血管病患者DTI脑微结构变化与一般认知功能和执行功能的独立相关性]

[Independent correlations of cerebral microstructural changes on DTI to general cognitive function and executive function in patients with subcortical ischemic vascular disease].

作者信息

Zhang Qiujuan, Guo Youmin, Bai Zhilan, Yang Junle, Zhang Gejuan, Xu Min

机构信息

Department of Diagnostic Imaging, Xi'an Jiaotong University College of Medicine, Xi'an, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2012 Feb;32(2):193-7.

PMID:22381756

Abstract

OBJECTIVE

To investigate whether DTI abnormalities in patients with nondemented subcortical ischemic vascular disease (SIVD) are correlated to general cognitive function and executive function independent of conventional MRI parameters.

METHODS

Sixty-six SIVD patients including 30 with cognitive impairment without dementia (VCIND) and 36 with normal cognition (NCI) underwent DTI and cognitive assessment of the general cognitive function and executive function. Conventional MRI parameters and DTI parameters were measured within the white matter lesions (WMLs), normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM). The independent predictors of general cognitive function and executive function in SIVD patients was analyzed.

RESULTS

NCI and VCIND patients showed significant differences in the periventricular WMLs, ADC valus in NAWM and WMLs of the centrum semiovale, and FA values in NAWM of the anterior periventricular. Except for ADC values of the caudate nucleus, ADC and FA values in the subcortical NAGM showed significant difference between the two groups. After controlling for age and education, PVLs and ADC values in the WMLs and NAWM of the centrum semiovale and putamen, and FA values in the anterior periventricular NAWM, WMLs and putamen showed significant correlations to MMSE; the number of lacunar infarcts, ADC values in posterior periventricular NAWM and caudate nucleus, and FA values in anterior periventricular NAWM and thalamus showed significant correlations to CDT. Multivariate analysis showed independent correlations of the ADC values in WMLs and NAWM of the centrum semiovale to MMSE, and demonstarted correlations of the ADC values of the caudate nucleus and number of lacunar infarcts to CDT.

CONCLUSION

In nondemented SIVD subjects, the integrity of the white matter in the centrum semiovale strongly correlates to the general cognition, and the microstructural damage of the caudate nucleus head predicts executive function impairment independent of other MRI variables.

摘要

目的

探讨非痴呆型皮质下缺血性血管病（SIVD）患者的弥散张量成像（DTI）异常是否与一般认知功能和执行功能相关，且独立于传统磁共振成像（MRI）参数。

方法

66例SIVD患者，包括30例无痴呆的认知障碍（VCIND）患者和36例认知正常（NCI）患者，接受了DTI检查以及一般认知功能和执行功能的认知评估。在白质病变（WMLs）、正常外观白质（NAWM）和正常外观灰质（NAGM）区域测量传统MRI参数和DTI参数。分析SIVD患者一般认知功能和执行功能的独立预测因素。

结果

NCI和VCIND患者在脑室周围WMLs、半卵圆中心NAWM和WMLs的表观扩散系数（ADC）值以及脑室前NAWM的各向异性分数（FA）值方面存在显著差异。除尾状核的ADC值外，两组皮质下NAGM的ADC和FA值也存在显著差异。在控制年龄和教育程度后，脑室周围白质病变（PVLs）、半卵圆中心和壳核的WMLs及NAWM中的ADC值，以及脑室前NAWM、WMLs和壳核中的FA值与简易精神状态检查表（MMSE）显著相关；腔隙性梗死数量、脑室后NAWM和尾状核的ADC值，以及脑室前NAWM和丘脑的FA值与连线测验（CDT）显著相关。多因素分析显示，半卵圆中心WMLs和NAWM中的ADC值与MMSE独立相关，尾状核的ADC值和腔隙性梗死数量与CDT相关。