Alfaro Freddy J, Lioutas Vasileios-Arsenios, Pimentel Daniela A, Chung Chen-Chih, Bedoya Francisco, Yoo Woo-Kyoung, Novak Vera
Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA.
Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
J Neurol. 2016 Dec;263(12):2505-2514. doi: 10.1007/s00415-016-8292-z. Epub 2016 Oct 11.
Subjects with metabolic syndrome (MetS) often show worse cognitive performance compared with the healthy population. We investigated whether microstructural white matter abnormalities are associated with cognitive performance in adults with MetS using diffusion tensor MR imaging. A total of 32 subjects with MetS (age 64.8 ± 7.8, 56.25 % female) and 23 age-, gender-, and education-matched healthy controls completed a battery of neuropsychological tests and diffusion tensor imaging (DTI) at 3-T MRI. Brain global and regional volumes, white matter fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (LD) were calculated. The least-square models adjusted for age, sex, HbA1c, hypertension, body mass index, hyperlipidemia, and white matter hyperintensities were used to evaluate the relationship between cognitive function and DTI. The MetS group had worse performance in verbal fluency (VF) and learning and memory function (total VF: T score (p = 0.01), VF: animals T score (p = 0.0001), Hopkins Verbal Learning Test (HVLT): Total recall T score (p = 0.0001), and HVLT: delayed recall T score (p = 0.002), as compared with controls. In the MetS group, abnormalities in diffusivity measures were associated with worse cognitive performance [VF: animals T score and left post-central gyrus-LD (p = 0.0007, r 0.4), R angular gyrus-RD (p = 0.0008, r 0.3), L supra-marginal gyrus-RD (p = 0.009, r 0.2) after adjusting for age, sex, HbA1c, 24 h mean BP, presence of hyperlipidemia, and global white matter hyperintensities]. Microstructural white matter abnormalities in the MetS group might be the underlying mechanisms of worse verbal learning and memory performance.
与健康人群相比，患有代谢综合征（MetS）的受试者通常表现出更差的认知能力。我们使用扩散张量磁共振成像研究了患有MetS的成年人中微观结构白质异常是否与认知能力相关。共有32名患有MetS的受试者（年龄64.8±7.8岁，56.25%为女性）和23名年龄、性别和教育程度匹配的健康对照者在3-T磁共振成像仪上完成了一系列神经心理学测试和扩散张量成像（DTI）。计算了脑总体积和区域体积、白质分数各向异性（FA）、平均扩散率（MD）、径向扩散率（RD）和轴向扩散率（LD）。采用针对年龄、性别、糖化血红蛋白、高血压、体重指数、高脂血症和白质高信号进行调整的最小二乘模型来评估认知功能与DTI之间的关系。与对照组相比，MetS组在言语流畅性（VF）以及学习和记忆功能方面表现更差（总VF：T分数（p=0.01），VF：动物T分数（p=0.0001），霍普金斯言语学习测试（HVLT）：总回忆T分数（p=0.0001），以及HVLT：延迟回忆T分数（p=0.002））。在MetS组中，扩散率测量异常与更差的认知能力相关[在针对年龄、性别、糖化血红蛋白、24小时平均血压、高脂血症的存在情况和总体白质高信号进行调整后，VF：动物T分数与左侧中央后回-LD（p=0.0007，r=0.4），右侧角回-RD（p=0.0008，r=0.3），左侧缘上回-RD（p=0.009，r=0.2）]。MetS组中微观结构白质异常可能是言语学习和记忆表现较差的潜在机制。
