Li Q, Zhao L Q, Hu F Y
Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan 030012, China.
Zhonghua Yi Xue Za Zhi. 2017 Dec 5;97(45):3529-3533. doi: 10.3760/cma.j.issn.0376-2491.2017.45.003.
To investigate the features of cognitive impairment and potential physiopathologic mechanism using neuropsychological assessment and resting state functional magnetic resonance imaging (rs-fMRI) in patients with leukoaraiosis (LA). A total of 13 patients with LA (LA group) and 13 healthy controls (NC group) from Shanxi Provincial People's Hospital between January and June 2016 were recruited. The two groups were matched for age, sex, education, and vascular risk factors. All the subjects underwent neuropsychological assessment and the scan of rs-fMRI. The neuropsychological scores and the brain areas had significant differences of cerebral spontaneous activity in resting state of the two groups were compared, and the relationship between the scores and the amplitude of low frequency fluctuation (ALFF) were evaluated in these areas. LA group was associated with comprehensive cognitive impairment, including minimum mental state examination (MMSE) (LA group: 23.3±10.7 vs NC group: 29.7±0.6), montreal cognitive assessment (MoCA) (22.7±10.7 vs 29.5±0.7), digit span test (DS) forwards (6.5±3.2 vs 8.7±1.1) and backwards (4.2±2.2 vs 6.2±0.9), trail making test (TMT) part A (168±136 vs 47±10), immediate memory (6.1±3.5 vs 11.0±2.2) and delayed memory (4.7±2.8 vs 11.0±2.4) of auditory verbal learning test (AVLT), Stroop B (60±34 vs 32±7) and C (127±72 vs 48±12), verbal similarity test (16.5±8.1 vs 23.1±2.5) (all <0.05). Compared with the NC group, patients with LA showed decreased ALFF in areas of the right posterior cingulate cortex (PCC), precuneus_R, cuneus, postcentral_R, precentral_R, calcarine_R (all <0.05). After adjustment for the influences of age, sex and education, the correlation analysis showed that right PCC, precuneus_R, cuneus, postcentral_R, etc, were closely related with cognitive impairment. Patients with LA exhibits significant cognitive impairment, such as executive function, memory, attention and information processing speed. And cognitive impairment of LA is related to abnormal cerebral spontaneous activity, especially in areas of right PCC, precuneus_R, cuneus, etc.
采用神经心理学评估和静息态功能磁共振成像（rs-fMRI）研究脑白质疏松症（LA）患者的认知障碍特征及潜在病理生理机制。选取2016年1月至6月山西省人民医院的13例LA患者（LA组）和13例健康对照者（NC组）。两组在年龄、性别、教育程度和血管危险因素方面相匹配。所有受试者均接受神经心理学评估和rs-fMRI扫描。比较两组静息状态下神经心理学评分及脑区自发活动存在显著差异的脑区，并评估这些脑区评分与低频振幅（ALFF）之间的关系。LA组存在全面认知障碍，包括简易精神状态检查表（MMSE）（LA组：23.3±10.7 vs NC组：29.7±0.6）、蒙特利尔认知评估量表（MoCA）（22.7±10.7 vs 29.5±0.7）、数字广度顺背（DS）（6.5±3.2 vs 8.7±1.1）和倒背（4.2±2.2 vs 6.2±0.9）、连线测验（TMT）A部分（168±136 vs 47±10）、听觉词语学习测验（AVLT）的即刻记忆（6.1±3.5 vs 11.0±2.2）和延迟记忆（4.7±2.8 vs 11.0±2.4）、Stroop B（60±34 vs 32±7）和C（127±72 vs 48±12）、词语相似性测验（16.5±8.1 vs 23.1±2.5）（均P<0.05）。与NC组相比，LA患者右侧后扣带回皮质（PCC）、右侧楔前叶、楔叶、右侧中央后回、右侧中央前回、右侧距状裂等区域ALFF降低（均P<0.05）。校正年龄、性别和教育程度的影响后，相关性分析显示右侧PCC、右侧楔前叶、楔叶、右侧中央后回等与认知障碍密切相关。LA患者存在明显的认知障碍，如执行功能、记忆、注意力和信息处理速度等方面。LA的认知障碍与大脑自发活动异常有关，尤其是在右侧PCC、右侧楔前叶、楔叶等区域。
