From the Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China.
Neurology. 2014 Mar 11;82(10):842-9. doi: 10.1212/WNL.0000000000000185. Epub 2014 Jan 31.
To assess the impact of intracranial arterial stenosis on the progression from mild cognitive impairment (MCI) to Alzheimer disease (AD).
A total of 423 participants with MCI were included and evaluated with clinical and neuropsychological examinations annually for 4 years. The incidence of dementia due to AD was investigated. CT angiography was used to measure the stenosis of major intracranial arteries in the studied population. A mixed-effects regression model was used to analyze the association between intracranial arterial stenosis and the progression of MCI, which was assessed with the Mini-Mental State Examination and the Activities of Daily Living scale. Cox proportional hazards models were used to identify the association between intracranial arterial stenosis and dementia progression.
At the end of the follow-up, 116 participants had progressed to dementia due to AD, while 223 remained in the MCI stage. Participants with moderate or severe intracranial arterial stenosis had a faster decline in cognition and function relative to participants without such stenosis. The presence of moderate or severe intracranial arterial stenosis significantly increased the risk of dementia progression, even after controlling for age, sex, education, vascular risk factors, and silent MRI lesions.
Intracranial arterial stenosis increased the risk of developing AD dementia after MCI.
评估颅内动脉狭窄对轻度认知障碍（MCI）向阿尔茨海默病（AD）进展的影响。
共纳入 423 名 MCI 患者，每年进行临床和神经心理学检查，为期 4 年。调查了因 AD 导致的痴呆的发生率。使用 CT 血管造影测量研究人群中主要颅内动脉的狭窄程度。使用混合效应回归模型分析颅内动脉狭窄与 MCI 进展之间的关系，采用简易精神状态检查和日常生活活动量表评估 MCI 的进展。使用 Cox 比例风险模型来确定颅内动脉狭窄与痴呆进展之间的关系。
随访结束时，116 名参与者进展为 AD 导致的痴呆，而 223 名参与者仍处于 MCI 阶段。与无此类狭窄的参与者相比，中度或重度颅内动脉狭窄的参与者认知和功能下降更快。即使在控制了年龄、性别、教育程度、血管危险因素和无声 MRI 病变后，中度或重度颅内动脉狭窄仍然显著增加了痴呆进展的风险。
颅内动脉狭窄增加了 MCI 后发生 AD 痴呆的风险。
