Wang Shuangkun, Yuan Junliang, Guo Xiaojuan, Teng Leilei, Jiang Hua, Gu Hua, Hu Wenli, Jiang Tao
Department of Radiology Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2017 Apr;96(17):e6703. doi: 10.1097/MD.0000000000006703.
Our study aimed to investigate the changes of white matter microstructure of cortico-subcortical pathways using diffusion tensor imaging (DTI), and to explore the relationship between abnormal parameters of DTI and cognitive function underlying in patients with leukoaraiosis (LA).A total of 42 patients with LA and 42 age- and sex-matched healthy controls were recruited from Beijing Chaoyang Hospital, Capital Medical University between January 2012 and December 2012. All the subjects underwent scans of conventional magnetic resonance imaging and DTI, and a comprehensive neuropsychological battery was utilized. The regions of interest (ROIs) were located at the white matter of centrum semiovale, anterior and posterior periventricular white matter, basal ganglia, corpus callosum. The averaged values of mean diffusivity (MD) and fractional anisotropy (FA) were quantified both within white matter lesions (WMLs) and normal appearing white matter (NAWM). A linear regression analysis was performed to assess the association between diffusion parameters and decline in cognitive domains.Patients with LA were associated with comprehensive cognitive function deficits. We found that significantly decreased FA and increased MD in WMLs at the 5 ROIs than that of NAWM and controls (P < .05). The values of FA in NAWM were significantly lower and MD in NAWM were significantly higher at centrum semiovale and posterior periventricular white matter than that of controls (P < .05). The values of FA in WMLs at anterior periventricular white matter were positively related to the performances of cognition in patients with LA (P < .05). The values of FA in NAWM located at anterior periventricular white matter were positively related to the score of Digit-symbol test (r = 0.446, P = .002). The values of FA in NAWM located at anterior periventricular white matter correlated inversely with the Z scores of executive function (r = -0.418, P = .03).In our study, patients with LA exhibited significant cognitive impairment especially in the domains of executive function. The technique of DTI revealed that the reduced FA and increased MD at the corresponding regions of cortico-subcortical pathways in patients with LA. DTI may be of great help for an early pathology of white matter microstructure underlying in patients with LA.
我们的研究旨在利用扩散张量成像（DTI）研究皮质 - 皮质下通路的白质微观结构变化，并探讨脑白质疏松症（LA）患者DTI异常参数与潜在认知功能之间的关系。2012年1月至2012年12月期间，从首都医科大学附属北京朝阳医院招募了42例LA患者和42例年龄及性别匹配的健康对照者。所有受试者均接受了常规磁共振成像和DTI扫描，并使用了一套全面的神经心理测试。感兴趣区域（ROIs）位于半卵圆中心、脑室周围前、后白质、基底神经节、胼胝体的白质。在脑白质病变（WMLs）和正常白质（NAWM）中均对平均扩散率（MD）和各向异性分数（FA）的平均值进行了量化。进行线性回归分析以评估扩散参数与认知领域下降之间的关联。LA患者存在全面的认知功能缺陷。我们发现，5个ROIs的WMLs中FA显著降低，MD升高，高于NAWM和对照组（P<0.05）。半卵圆中心和脑室周围后白质的NAWM中FA值显著低于对照组，MD值显著高于对照组（P<0.05）。脑室周围前白质WMLs中的FA值与LA患者的认知表现呈正相关（P<0.05）。位于脑室周围前白质的NAWM中的FA值与数字符号测试得分呈正相关（r = 0.446，P = 0.002）。位于脑室周围前白质的NAWM中的FA值与执行功能的Z评分呈负相关（r = -0.418，P = 0.03）。在我们的研究中，LA患者表现出明显的认知障碍，尤其是在执行功能领域。DTI技术显示，LA患者皮质 - 皮质下通路相应区域的FA降低，MD升高。DTI可能对LA患者潜在的白质微观结构早期病理学有很大帮助。
