Department of Internal Medicine, Guangzhou Eighth People's Hospital, Guangzhou, China.
J Clin Neurosci. 2012 May;19(5):718-22. doi: 10.1016/j.jocn.2011.07.052.
Abnormal diffusion tensor imaging (DTI) results have been observed in the periventricular white matter in patients with ischemic leukoaraiosis (ILA). However, the underlying pathological changes and their relationship to cognitive impairments are obscure. In addition, damage in the thalamus, an important structure in the executive function network, has been suggested in ILA, but is poorly understood. Twenty patients with ILA and 20 healthy volunteers with similar ages and educational histories underwent DTI, magnetic resonance spectroscopy (MRS) and a neuropsychological assessment. In patients with ILA, we observed an increased mean diffusivity (MD) and decreased levels of N-acetylaspartate (NAA)/creatine (Cr) in the anterior and posterior periventricular region and the thalamus, as well as decreased fractional anisotropy (FA) in the anterior and posterior periventricular regions. MD and NAA/Cr levels in the anterior and posterior periventricular white matter and NAA/Cr levels in the thalamus were correlated with executive function. DTI and MRS abnormalities were consistent with axonal and/or neuronal loss and dysfunction in the anterior and posterior periventricular white matter and the thalamus. This study demonstrates that DTI and MRS techniques can be used to investigate pathological changes in the anterior and posterior periventricular white matter and the thalamus; these changes may be correlated with executive functional changes in patients with ILA.
异常的扩散张量成像（DTI）结果已在缺血性白质病（ILA）患者的脑室周围白质中观察到。然而，其潜在的病理变化及其与认知障碍的关系尚不清楚。此外，ILA 中被认为存在丘脑的损伤，这是执行功能网络中的一个重要结构，但了解甚少。20 例 ILA 患者和 20 名年龄和教育背景相似的健康志愿者接受了 DTI、磁共振波谱（MRS）和神经心理学评估。在 ILA 患者中，我们观察到在前脑室周围区和丘脑的平均弥散度（MD）增加，N-乙酰天门冬氨酸（NAA）/肌酸（Cr）水平降低，前脑室周围区的各向异性分数（FA）降低。前脑室周围白质和丘脑的 MD 和 NAA/Cr 水平与执行功能相关。前脑室周围白质和丘脑的 DTI 和 MRS 异常与轴突和/或神经元丢失和功能障碍一致。这项研究表明，DTI 和 MRS 技术可用于研究前脑室周围白质和丘脑的病理变化；这些变化可能与 ILA 患者的执行功能变化相关。
