Yuan Jun-liang, Wang Shuang-kun, Guo Xiao-juan, Peng Peng, Gu Hua, Zhao Wen-hui, Niu Shi-qin, Hu Wen-li
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, China.
Zhonghua Yi Xue Za Zhi. 2012 Feb 7;92(5):303-6.
To explore the pathological changes in patients with leukoaraiosis (LA) by magnetic resonance spectroscopy (MRS) and examine its relationship with cognitive function.
Twenty-three LA patients and 23 age and gender-matched healthy subjects were recruited from the Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University between August 2010 and November 2010. All participants underwent the neuropsychological tests. Multi-voxel chemical shift imaging was performed and the regions of interest were positioned in bilateral frontal white matter. The relative metabolite ratios, involving N-acetyl aspartate/choline ratio (NAA/Cho), N-acetyl aspartate/creatine (NAA/Cr) and choline/creatine (Cho/Cr), were estimated. The correlation of the MRS data and the performance of cognitive function was analyzed.
The LA patients were associated with a worse performance of mini mental state examination (MMSE) versus the healthy controls (24 ± 3 vs 28 ± 1, P < 0.05). Univariate analysis of the MRS data revealed the ratios of NAA/Cho and NAA/Cr significantly decreased in bilateral frontal white matter lesions in the LA group versus the control group (1.72 ± 0.20 vs 1.96 ± 0.36, 1.67 ± 0.17 vs 1.85 ± 0.21, P < 0.05). The values of NAA/Cr and NAA/Cho in normal appearing white matter increased versus the LA group (1.83 ± 0.24 vs 1.72 ± 0.20, 1.78 ± 0.28 vs 1.67 ± 0.17) and decreased versus the control group (1.83 ± 0.24 vs 1.96 ± 0.36, 1.78 ± 0.28 vs 1.85 ± 0.21). But no significant differences were found (P > 0.05). The ratio of Cho/Cr did not differ among 3 groups (P > 0.05). The pathological change of NAA/Cr in white matter lesion in LA patients was markedly correlated with the performance of MMSE (r = 0.47, P < 0.05).
NAA may be a marker of axonal loss/dysfunction in LA patients. And the changes of NAA/Cr have a positive correlation with cognitive impairment.
通过磁共振波谱（MRS）探讨脑白质疏松症（LA）患者的病理变化，并研究其与认知功能的关系。
2010年8月至2010年11月期间，从首都医科大学附属北京朝阳医院神经内科招募了23例LA患者和23例年龄、性别匹配的健康受试者。所有参与者均接受神经心理学测试。进行多体素化学位移成像，并将感兴趣区域定位在双侧额叶白质。估计相对代谢物比率，包括N-乙酰天门冬氨酸/胆碱比率（NAA/Cho）、N-乙酰天门冬氨酸/肌酸（NAA/Cr）和胆碱/肌酸（Cho/Cr）。分析MRS数据与认知功能表现之间的相关性。
与健康对照组相比，LA患者的简易精神状态检查表（MMSE）表现较差（24±3 vs 28±1，P<0.05）。对MRS数据进行单因素分析显示，与对照组相比，LA组双侧额叶白质病变中NAA/Cho和NAA/Cr比率显著降低（1.72±0.20 vs 1.96±0.36，1.67±0.17 vs 1.85±0.21，P<0.05）。与LA组相比，正常白质中NAA/Cr和NAA/Cho值升高（1.83±0.24 vs 1.72±0.20，1.78±0.28 vs 1.67±0.17），与对照组相比降低（1.83±0.24 vs 1.96±0.36，1.78±0.28 vs 1.85±0.21）。但未发现显著差异（P>0.05）。3组之间Cho/Cr比率无差异（P>0.05）。LA患者白质病变中NAA/Cr的病理变化与MMSE表现显著相关（r=0.47，P<0.05）。
NAA可能是LA患者轴突丢失/功能障碍的标志物。并且NAA/Cr的变化与认知障碍呈正相关。
