Department of Psychiatry and Neuropathobiology, Graduate School of Medical Science, Kumamoto University, Japan.
Int J Geriatr Psychiatry. 2013 Jan;28(1):18-25. doi: 10.1002/gps.3781. Epub 2012 Mar 7.
Cerebral small vessel disease (SVD) is frequently observed in patients with Alzheimer's disease (AD). However, the association between SVD and clinical symptoms exhibited by patients with AD remains unclear. This study examined the association of SVD as observed on magnetic resonance imaging (MRI) with behavioural and psychological symptoms of dementia and cognitive function of patients with probable AD.
A total of 163 consecutive patients (55 men, 108 women) with probable AD were included in this cross-sectional study of a prospective cohort. Patients were divided into two groups based on the presence or absence of cerebral SVD [white matter hyperintensities (WMH) grade 0/1 (Fazekas scale) and no lacunes: SVD absent, WMH grade 2/3 (Fazekas scale) or the number of lacunes ≥1: SVD present]. Cognitive functions were assessed using the Mini mental state examination, word recall and recognition subtests in the Alzheimer's Disease Assessment Scale-Cognitive Subscale, as well as the letter fluency task and the category fluency task. Psychiatric symptoms were rated according to Neuropsychiatric Inventory.
Patients with probable AD with cerebral SVD had significantly more delusions and depression than those without SVD. No significant differences were observed in other neuropsychiatric symptoms, MMSE or word recall and recognition tests between both groups.
Our results suggest that cerebral SVD observed on MRI of patients with AD is associated with delusions and depression.
脑小血管病（SVD）在阿尔茨海默病（AD）患者中经常观察到。然而，SVD 与 AD 患者表现出的临床症状之间的关系尚不清楚。本研究检查了磁共振成像（MRI）上观察到的 SVD 与可能的 AD 患者的痴呆行为和心理症状以及认知功能的关系。
这项前瞻性队列的横断面研究共纳入了 163 例连续的可能 AD 患者（55 名男性，108 名女性）。根据是否存在脑 SVD[脑白质高信号（WMH）分级 0/1（Fazekas 量表）和无脑腔：SVD 不存在，WMH 分级 2/3（Fazekas 量表）或腔隙数≥1：SVD 存在]将患者分为两组。使用阿尔茨海默病评估量表认知子量表中的简易精神状态检查、单词回忆和识别子测验，以及字母流畅性任务和类别流畅性任务评估认知功能。根据神经精神疾病问卷对精神症状进行评分。
患有 AD 合并脑 SVD 的患者比不合并 SVD 的患者更易出现妄想和抑郁。两组之间在其他神经精神症状、MMSE 或单词回忆和识别测试方面无显著差异。
我们的结果表明，AD 患者 MRI 上观察到的脑 SVD 与妄想和抑郁有关。
