Ogama Noriko, Sakurai Takashi, Saji Naoki, Nakai Toshiharu, Niida Shumpei, Toba Kenji, Umegaki Hiroyuki, Kuzuya Masafumi
Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
Dement Geriatr Cogn Dis Extra. 2018 Apr 11;8(1):138-150. doi: 10.1159/000486826. eCollection 2018 Jan-Apr.
BACKGROUND/AIMS: Behavioral and psychological symptoms of dementia (BPSD) are exhibited in most patients with Alzheimer disease (AD). Although white matter hyperintensity (WMH) is often observed with AD, the precise role of WMH in BPSD remains unclear. The current study aimed to identify the impact of regional WMH on specific features of BPSD in persons with mild to moderate AD and amnestic mild cognitive impairment (aMCI).
A sample of 256 female outpatients with AD ( = 217) and aMCI ( = 39) were recruited. We assessed BPSD using the Dementia Behavior Disturbance Scale. WMH and brain atrophy were evaluated using an automatic segmentation program. Regional WMH was evaluated as periventricular hyperintensity (PVH) and deep WMH in frontal, temporal, occipital, and parietal lobes.
Whole-brain WMH was associated with verbal aggressiveness. In multivariate analysis, PVH in the frontal lobe was independently associated with verbal aggressiveness after adjustment for brain atrophy and clinical confounders.
The current results indicated that PVH in the frontal lobe was independently associated with verbal aggressiveness.
背景/目的：大多数阿尔茨海默病（AD）患者会出现痴呆的行为和心理症状（BPSD）。虽然AD患者常伴有白质高信号（WMH），但WMH在BPSD中的确切作用仍不清楚。本研究旨在确定区域WMH对轻度至中度AD和遗忘型轻度认知障碍（aMCI）患者BPSD特定特征的影响。
招募了256名患有AD（n = 217）和aMCI（n = 39）的女性门诊患者。我们使用痴呆行为障碍量表评估BPSD。使用自动分割程序评估WMH和脑萎缩。根据脑室周围高信号（PVH）以及额叶、颞叶、枕叶和顶叶的深部WMH来评估区域WMH。
全脑WMH与言语攻击性相关。在多变量分析中，调整脑萎缩和临床混杂因素后，额叶的PVH与言语攻击性独立相关。
目前的结果表明，额叶的PVH与言语攻击性独立相关。
