Kim Geon Ha, Seo Sang Won, Jung Kihyo, Kwon Oh-Hun, Kwon Hunki, Kim Jong Hun, Roh Jee Hoon, Kim Min-Jeong, Lee Byung Hwa, Yoon Doo Sang, Hwang Jung Won, Lee Jong Min, Jeong Jee Hyang, You Heecheon, Heilman Kenneth M, Na Duk L
Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Neurol. 2016 Jan;263(1):89-99. doi: 10.1007/s00415-015-7946-6. Epub 2015 Oct 29.
Subcortical vascular cognitive impairment (SVCI) refers to cognitive impairment associated with small vessel disease. Motor intentional disorders (MID) have been reported in patients with SVCI. However, there are no studies exploring the neuroanatomical regions related to MID in SVCI patients. The aim of this study, therefore, was to investigate the neural correlates of MID in SVCI patients. Thirty-one patients with SVCI as well as 10 healthy match control participants were included. A "Pinch-Grip" apparatus was used to quantify the force control capabilities of the index finger in four different movement phases including initiation, development, maintenance, and termination. All participants underwent magnetic resonance imaging (MRI). Topographical cortical areas and white matter tracts correlated with the performances of the four different movement phases were assessed by the surface-based morphometry and tract-based spatial statistics analyses. Poorer performance in the maintenance task was related to cortical thinning in bilateral dorsolateral prefrontal, orbitofrontal and parietal cortices, while poorer performance in the termination task was associated with the disruption of fronto-parietal cortical areas as well as the white matter tracts including splenium and association fibers such as superior longitudinal fasciculus. Our study demonstrates that cortical areas and underlying white matter tracts associated with fronto-parietal attentional system play an important role in motor impersistence and perseveration in SVCI patients.
皮质下血管性认知障碍(SVCI)是指与小血管疾病相关的认知障碍。已有报道称SVCI患者存在运动意向障碍(MID)。然而,尚无研究探讨SVCI患者中与MID相关的神经解剖区域。因此,本研究的目的是调查SVCI患者中MID的神经关联。研究纳入了31例SVCI患者以及10名健康对照者。使用“捏握”装置在包括起始、发展、维持和终止的四个不同运动阶段量化食指的力控制能力。所有参与者均接受了磁共振成像(MRI)检查。通过基于表面的形态学测量和基于体素的空间统计学分析评估与四个不同运动阶段表现相关的地形学皮质区域和白质束。维持任务表现较差与双侧背外侧前额叶、眶额叶和顶叶皮质变薄有关,而终止任务表现较差与额顶叶皮质区域以及包括胼胝体和上纵束等联合纤维的白质束中断有关。我们的研究表明,与额顶叶注意力系统相关的皮质区域和潜在白质束在SVCI患者的运动不持续和持续性方面起重要作用。