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轻度认知障碍患者白质病变对脑灌注的影响。

Effects of white matter lesions on brain perfusion in patients with mild cognitive impairment.

作者信息

Ishibashi Masato, Kimura Noriyuki, Aso Yasuhiro, Matsubara Etsuro

机构信息

Department of Neurology, Oita University, Faculty of Medicine, Japan.

Department of Neurology, Oita University, Faculty of Medicine, Japan.

出版信息

Clin Neurol Neurosurg. 2018 May;168:7-11. doi: 10.1016/j.clineuro.2018.02.030. Epub 2018 Feb 24.

Abstract

OBJECTIVE

To evaluate the effects of white matter lesions on regional cerebral blood flow in subjects with amnestic mild cognitive impairment.

PATIENTS AND METHODS

Seventy-five subjects with mild cognitive impairment (36 men and 39 women; mean age, 78.1 years) were included in the study. We used the Mini-Mental State Examination to assess cognitive function. All subjects underwent brain magnetic resonance imaging and Tc ethylcysteinate dimer single photon emission computed tomography. Subjects were stratified based on the presence or absence of white matter lesions on magnetic resonance imaging. Statistical parametric mapping of differences in regional cerebral blood flow between the two groups were assessed by voxel-by-voxel group analysis using SPM8.

RESULTS

Of all 75 subjects with mild cognitive impairment, 46 (61.3%) had mild to moderate white matter lesions. The prevalence of hypertension tended to be higher in subjects with white matter lesions than in those without white matter lesions. Mini-Mental State Examination scores were significantly lower in subjects with white matter lesions than in those without white matter lesions. Subjects with white matter lesions had decreased regional cerebral blood flow mainly in the frontal, parietal, and medial temporal lobes, as well as the putamen, compared to those without white matter lesions.

CONCLUSION

In subjects with mild cognitive impairment, white matter lesions were associated with cognitive impairment and mainly frontal lobe brain function.

摘要

目的

评估遗忘型轻度认知障碍患者白质病变对局部脑血流的影响。

患者与方法

本研究纳入了75例轻度认知障碍患者(36例男性和39例女性;平均年龄78.1岁)。我们使用简易精神状态检查表评估认知功能。所有受试者均接受了脑磁共振成像和锝-乙胱氨酸二聚体单光子发射计算机断层扫描。根据磁共振成像上白质病变的有无对受试者进行分层。使用SPM8通过逐体素组分析评估两组之间局部脑血流差异的统计参数映射。

结果

在所有75例轻度认知障碍患者中,46例(61.3%)有轻度至中度白质病变。有白质病变的受试者中高血压患病率往往高于无白质病变的受试者。有白质病变的受试者简易精神状态检查表得分显著低于无白质病变的受试者。与无白质病变的受试者相比,有白质病变的受试者局部脑血流主要在额叶、顶叶、颞叶内侧以及壳核减少。

结论

在轻度认知障碍患者中,白质病变与认知障碍及主要是额叶脑功能相关。

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