Beauchet Olivier, Allali Gilles, Annweiler Cédric, Verghese Joe
Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research and Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Centre of Excellence on Aging and Chronic Diseases of McGill integrated University Health Network, Montreal, Quebec, Canada.
Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland. Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York.
J Gerontol A Biol Sci Med Sci. 2016 Aug;71(8):1081-8. doi: 10.1093/gerona/glw012. Epub 2016 Mar 4.
The "motoric cognitive risk" (MCR) syndrome is a newly reported predementia syndrome combining cognitive complaint and slow gait speed. We hypothesized that individuals with MCR syndrome would have lower brain volumes compared with non-MCR individuals. This study aims (i) to compare the cognitive profile of nondemented older community-dwellers with and without MCR syndrome and (ii) to examine association of global and regional brain volumes with MCR syndrome.
A total of 171 individuals (28 MCR and 143 non-MCR) were included in this cross-sectional study. Total white matter abnormalities, total white matter, total cortical and subcortical gray matters, hippocampus, motor cortex, premotor cortex, and prefrontal cortex were examined. Brain volumes were quantified from a three-dimensional T1-weighted magnetic resonance imaging using semi-automated software. Age, gender, education level, number of drugs taken daily, use of psychoactive drugs, and cognitive profile were also measured.
The distribution of cognitively healthy individuals and those with mild cognitive impairment was not different in participants with and without MCR. Multiple logistic regression models showed that smaller volumes of total gray matter (p = .016), total cortical gray matter (p = .010), premotor cortex (p = .018), prefrontal cortex (p = .026), and dorsolateral segment of prefrontal cortex (p = .032) were associated with MCR status. The premotor cortex presented the highest mean difference for brain regional volume between MCR and non-MCR participants (p = .03).
The findings revealed similar cognitive profile in MCR and non-MCR participants, and MCR-related smaller global and regional gray matter volumes involving premotor and prefrontal cortices, suggesting that the MCR syndrome may predict cortical neurodegenerative dementia more than subcortical dementia.
“运动认知风险”(MCR)综合征是一种新报道的痴呆前期综合征,其兼具认知主诉和步态缓慢的特点。我们推测,与非MCR个体相比,MCR综合征个体的脑容量会更低。本研究旨在(i)比较有无MCR综合征的非痴呆老年社区居民的认知特征,以及(ii)研究全脑和局部脑容量与MCR综合征的相关性。
本横断面研究共纳入171名个体(28名MCR个体和143名非MCR个体)。检测了总的白质异常、总的白质、总的皮质和皮质下灰质、海马体、运动皮质、运动前皮质和前额叶皮质。使用半自动软件从三维T1加权磁共振成像中对脑容量进行定量分析。还测量了年龄、性别、教育水平、每日服用药物数量、精神活性药物的使用情况以及认知特征。
有无MCR的参与者中,认知健康个体和轻度认知障碍个体的分布没有差异。多元逻辑回归模型显示,总的灰质(p = 0.016)、总的皮质灰质(p = 0.010)、运动前皮质(p = 0.018)、前额叶皮质(p = 0.026)和前额叶皮质背外侧段(p = 0.032)体积较小与MCR状态相关。运动前皮质在MCR和非MCR参与者之间的脑区体积平均差异最大(p = 0.03)。
研究结果显示,MCR和非MCR参与者的认知特征相似,且MCR相关的全脑和局部灰质体积较小,累及运动前皮质和前额叶皮质,这表明MCR综合征可能比皮质下痴呆更能预测皮质神经退行性痴呆。