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缺血性脑血管病患者脑微出血部位与认知障碍的关系

Relationship between cerebral microbleeds location and cognitive impairment in patients with ischemic cerebrovascular disease.

作者信息

Yang Jianjun, Lyu Yongtao, Ma Yue, Chen Yan

机构信息

Department of Geriatric Medicine, Shandong Provincial Third Hospital, Jinan, People's Republic of China.

出版信息

Neuroreport. 2018 Sep 26;29(14):1209-1213. doi: 10.1097/WNR.0000000000001098.

Abstract

Cerebral microbleeds (CMBs) have been identified as an important manifestation and diagnostic marker of cerebrovascular disease, but there are also some controversies about the impact of CMBs on cognition. The current cross-sectional study aimed to clarify the relationship between CMBs and cognitive impairment in patients with ischemic cerebrovascular disease. One hundred and fifty patients with lacunar infarction or transient ischemic attack were screened, and all of them were scanned by brain MRI. In the end, 125 patients who were divided into a CMBs group and a non-CMBs group were selected and completed the cognitive tests. Cognitive Function Assessment was performed using the Montreal Cognitive Assessment scale. Images of CMBs were assessed using a susceptibility-weighted imaging measure. Associations between cognitive function and the location of CMBs were determined. There was no significant difference in the demographic and clinical features between the two groups of patients. Compared with participants with no CMBs, the CMBs group showed a greater impairment in cognitive parameters and specifically in performance on three cognitive domains: visual space and executive function, memory, and abstract thinking. Basal ganglia-thalamic was associated with memory and visual space and executive function. Relationships between cortical-subcortical and abstract thinking became significant. Furthermore, the mixed region was related to memory, abstract thinking, and visual space and executive function. In summary, patients with CMBs had a greater impairment in cognitive parameters in ischemic cerebrovascular disease and CMBs location was associated with different cognitive parameters, adding to our understanding of the cognitive effects of CMBs in cerebrovascular disease.

摘要

脑微出血(CMBs)已被确认为脑血管疾病的一种重要表现和诊断标志物,但关于CMBs对认知的影响也存在一些争议。当前的横断面研究旨在阐明缺血性脑血管疾病患者中CMBs与认知障碍之间的关系。筛选了150例腔隙性脑梗死或短暂性脑缺血发作患者,所有患者均接受了脑部MRI扫描。最终,选取了125例患者分为CMBs组和非CMBs组,并完成了认知测试。使用蒙特利尔认知评估量表进行认知功能评估。使用磁敏感加权成像测量评估CMBs图像。确定认知功能与CMBs位置之间的关联。两组患者的人口统计学和临床特征无显著差异。与无CMBs的参与者相比,CMBs组在认知参数方面表现出更大的损害,特别是在三个认知领域的表现:视觉空间与执行功能、记忆和抽象思维。基底节-丘脑与记忆、视觉空间和执行功能相关。皮质-皮质下与抽象思维之间的关系变得显著。此外,混合区域与记忆、抽象思维、视觉空间和执行功能相关。总之,缺血性脑血管疾病中CMBs患者的认知参数损害更大,且CMBs位置与不同认知参数相关,这增加了我们对脑血管疾病中CMBs认知效应的理解。

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