Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia.
Psychiatry Res. 2013 Oct 30;214(1):16-23. doi: 10.1016/j.pscychresns.2013.05.010. Epub 2013 Aug 2.
White matter changes (WMC) are common magnetic resonance imaging (MRI) findings, particularly in the elderly. Recent studies such as the Leukoaraiosis and Disability Study (LADIS) have found that WMC relate to adverse outcomes including cognitive impairment, depression, disability, unsteadiness and falls in cross-sectional and follow-up studies. Frontostriatal (or frontosubcortical) brain circuits may serve many of these functions, with the caudate nuclei playing a role in convergence of cognitive functions. This study aimed to determine whether reduced caudate volume relates to cognitive functions (executive functions, memory functions and speed of processing) and WMC. We determined caudate nuclei volumes, through manual tracing, on a subgroup of the LADIS study (n=66) from four centres with baseline and 3-year follow-up MRI scans. Regression analysis was used to assess relationships between caudate volume, cognitive function and WMC. Severity of WMC did not relate to caudate volume. Smaller caudate volumes were significantly associated with poorer executive functioning at baseline and at 3 years, but were not associated with scores of memory or speed of processing. Thus, in patients with WMC, a surrogate of small vessel disease, caudate atrophy relates to the dysexecutive syndrome, supporting the role of caudate as an important part of the frontostriatal circuit.
脑白质改变（WMC）是磁共振成像（MRI）的常见表现，尤其在老年人中更为常见。最近的研究，如白质病变和残疾研究（LADIS），发现 WMC 与认知障碍、抑郁、残疾、不稳和跌倒等不良结局相关，这些结局在横断面和随访研究中都有发现。额-纹状体（或额-皮质下）脑回路可能具有这些功能，尾状核在认知功能的收敛中发挥作用。本研究旨在确定尾状核体积是否与认知功能（执行功能、记忆功能和处理速度）和 WMC 相关。我们通过手动追踪，在 LADIS 研究的一个亚组（n=66）中确定了尾状核体积，该亚组来自四个中心，具有基线和 3 年的 MRI 随访扫描。回归分析用于评估尾状核体积、认知功能和 WMC 之间的关系。WMC 的严重程度与尾状核体积无关。较小的尾状核体积与基线和 3 年时的执行功能较差显著相关，但与记忆或处理速度的评分无关。因此，在有 WMC（小血管疾病的替代物）的患者中，尾状核萎缩与执行功能障碍综合征相关，支持尾状核作为额-纹状体回路的重要组成部分的作用。
