Moon So Young, de Souto Barreto Philipe, Chupin Marie, Mangin Jean François, Bouyahia Ali, Fillon Ludovic, Andrieu Sandrine, Vellas Bruno
Gérontopôle of Toulouse, University Hospital of Toulouse (CHU-Toulouse), Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France; Department of Neurology, Ajou University, School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, Kyungki-do 443-721, Republic of Korea.
Gérontopôle of Toulouse, University Hospital of Toulouse (CHU-Toulouse), Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France.
J Neurol Sci. 2017 Aug 15;379:266-270. doi: 10.1016/j.jns.2017.06.031. Epub 2017 Jun 20.
We investigated whether the baseline level and overtime changes of white matter hyperintensities (WMH) would be associated with cognitive decline over three years in non-demented older adults with memory complaints. 109 participants with baseline magnetic resonance imaging (MRI) and follow-up cognitive assessments up to 3-year were included; among them, 82 also had a follow-up MRI assessment over three years. WMH volume was obtained by an automated segmentation algorithm. Baseline WMH volumes and change between baseline and follow-up WMH were related to cognitive scores over time using mixed-effect linear regressions. Secondary stratified analyses according to Clinical Dementia Rating (CDR) status, APOE4 status, and presence of amyloid in the brain were conducted using similar regression models. Change in WMH volume overtime was associated with declines in COWAT (β=-0.239; 95% CI=-0.381, -0.096, p=0.001). Baseline WMH was not associated to any of the cognitive tests. Secondary analysis found that baseline WMH was associated to declines in TMT-A in APOE4 non-carriers (β=0.343; 95% CI=0.121, 0.564, p=0.003) and CDR 0 groups (β=0.307; 95% CI=0.095, 0.519, p=0.005); in CDR 0 group, overtime changes in WMH was associated to declines on both TMT-A (β=0.698; 95% CI=0.270, 1.126, p=0.002) and TMT-B (β=2.573; 95% CI=1.200, 3.947, p<0.001). Changes in WMH volume are associated with declines in information processing speed and executive function in non-demented older adults with memory complaints. Overtime changes in WMH volume is probably a better determinant of cognitive function in the elderly than baseline WMH volume.
我们调查了在有记忆障碍的非痴呆老年人中,脑白质高信号(WMH)的基线水平和随时间的变化是否与三年间的认知衰退相关。纳入了109名有基线磁共振成像(MRI)及长达3年的随访认知评估的参与者;其中82人还进行了为期三年的随访MRI评估。通过自动分割算法获得WMH体积。使用混合效应线性回归分析基线WMH体积以及基线与随访期间WMH的变化与随时间的认知分数之间的关系。根据临床痴呆评定量表(CDR)状态、APOE4状态和脑内淀粉样蛋白的存在情况进行二级分层分析,采用类似的回归模型。WMH体积随时间的变化与COWAT评分下降相关(β=-0.239;95%CI=-0.381,-0.096,p=0.001)。基线WMH与任何认知测试均无关联。二级分析发现,基线WMH与APOE4非携带者(β=0.343;95%CI=0.121,0.564,p=0.003)和CDR 0组(β=0.307;95%CI=0.095,0.519,p=0.005)的TMT-A评分下降相关;在CDR 0组中,WMH随时间的变化与TMT-A(β=0.698;95%CI=0.270,1.126,p=0.002)和TMT-B(β=2.573;95%CI=1.200,3.947,p<0.001)评分下降相关。在有记忆障碍且无痴呆的老年人中,WMH体积的变化与信息处理速度和执行功能的下降相关。WMH体积随时间的变化可能比基线WMH体积更能决定老年人的认知功能。