Center for Emotional and Behavioral Disorders, Hizen National Hospital, Saga, Japan; and the Second Department of Internal Medicine, Kyushu University, Fukuoka, Japan.
J Stroke Cerebrovasc Dis. 2000 Jul-Aug;9(4):172-5. doi: 10.1053/jscd.2000.7218.
Our previous study showed that deep white matter lesions (DWML) were associated with subtle cognitive decline in community-dwelling elderly people. However, even extensive (EXT)-DWML, found in 7 (4%) of 178 subjects aged 60 years or older, did not cause dementia. The purpose of the present study was to investigate brain circulation in nondemented elderly subjects with EXT-DWML. We compared cerebral blood flow in the deep white matter and frontal cortex between 5 subjects with EXT-DWML and 5 without such lesions, using a xenon-enhanced computed tomography (CT) method. Although the difference of deep white matter findings on magnetic resonance imaging (MRI) was the greatest possible (i.e., extensive v no or minimum lesions), cerebral blood flow values in anterior deep white matter and frontal cortex were 21.4 ± 5.3 standard deviation (SD) mL/100 g/minute and 42.7 ± 4.1, respectively, in subjects with extensive lesions, which were not significantly different from 24.3 ± 4.3 and 44.0 ± 7.1 in subjects without DWML. The present study suggests that EXT-DWML in nondemented elderly individuals do not necessarily indicate apparent hypoperfusion or marked cognitive decline.
我们之前的研究表明，深部脑白质病变（DWML）与社区居住的老年人认知能力的轻微下降有关。然而，即使在 178 名年龄在 60 岁或以上的受试者中发现了 7 名（4%）广泛（EXT）-DWML，也没有导致痴呆。本研究的目的是研究无痴呆的 EXT-DWML 老年受试者的脑循环。我们使用氙增强计算机断层扫描（CT）方法比较了 5 名 EXT-DWML 受试者和 5 名无此类病变受试者的深部白质和额叶皮质的脑血流。尽管磁共振成像（MRI）上深部白质病变的差异可能最大（即广泛病变与无病变或最小病变），但在 EXT 病变受试者中，前深部白质和额叶皮质的脑血流值分别为 21.4 ± 5.3 标准差（SD）mL/100 g/min 和 42.7 ± 4.1，与无 DWML 病变的受试者的 24.3 ± 4.3 和 44.0 ± 7.1 无显著差异。本研究表明，无痴呆的老年个体中的 EXT-DWML 不一定表示明显的灌注不足或明显的认知下降。
