Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.
Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
J Gerontol A Biol Sci Med Sci. 2019 May 16;74(6):884-889. doi: 10.1093/gerona/gly158.
Motoric cognitive risk (MCR) syndrome is a predementia syndrome characterized by slow gait and cognitive complaint that predicts both Alzheimer's disease and vascular dementia. Yet, we know very little about the brain structures and brain pathologies associated with MCR. The aim of this study was to identify gray matter (GM) networks associated with MCR.
We used voxel-based morphometry and multivariate covariance-based statistics to identify GM networks associated with MCR in a pooled sample of 267 older adults without dementia from three different cohorts-two North American cohorts and one French cohort.
The mean age of participants was 75.63 years, 50.56% identified as female, 57.68% had ≥13 years of education, and 5.99% had a prior history of stroke. A total of 14.23% participants met criteria for MCR. We identified a significant GM volume covariance pattern that was associated with MCR-even after adjusting for age, sex, education, mild cognitive impairment, stroke, total intracranial volume, and cohort status. This GM volume covariance network was primarily composed of supplementary motor, insular, and prefrontal cortex regions.
These findings suggest that MCR is primarily associated with GM atrophy in brain regions previously linked to the control aspects of gait such as motor planning and modulation rather than the motor aspects of gait such as gait initiation and maintenance.
运动认知风险（MCR）综合征是一种以运动缓慢和认知主诉为特征的前驱痴呆综合征，可预测阿尔茨海默病和血管性痴呆。然而，我们对与 MCR 相关的大脑结构和脑病理学知之甚少。本研究旨在确定与 MCR 相关的灰质（GM）网络。
我们使用基于体素的形态测量学和基于多元协方差的统计学方法，在来自三个不同队列的 267 名无痴呆的老年参与者的混合样本中，确定与 MCR 相关的 GM 网络——两个北美队列和一个法国队列。
参与者的平均年龄为 75.63 岁，50.56%为女性，57.68%受过≥13 年教育，5.99%有中风史。共有 14.23%的参与者符合 MCR 标准。我们确定了一个与 MCR 显著相关的 GM 体积协方差模式——即使在调整了年龄、性别、教育、轻度认知障碍、中风、总颅内体积和队列状况后也是如此。该 GM 体积协方差网络主要由辅助运动、脑岛和前额叶皮层区域组成。
这些发现表明，MCR 主要与大脑区域的 GM 萎缩有关，这些区域先前与步态的控制方面有关，如运动计划和调节，而不是与步态的运动方面有关，如步态启动和维持。
