Department of Neurology, Bayindir Icerenkoy Hospital, Atasehir, Istanbul, Turkey.
Department of Clinical Psychology, Bayindir Icerenkoy Hospital, Atasehir, Istanbul, Turkey.
Can J Neurol Sci. 2019 Jan;46(1):71-78. doi: 10.1017/cjn.2018.333. Epub 2018 Nov 12.
As cognitive impairment increases with age, sulcal atrophy (SA) and the enlargement of the ventricles also increase. Considering the measurements on the previously proposed visual scales, a new scale is proposed in this study that allows us to evaluate the atrophy, white matter hyperintensities (WMHs), basal ganglia infarct (BGI), and infratentorial infarct (ITI) together. Our aim of this study is to propose a practical and standardized MRI for the clinicians to be used in daily practice.
A total of 97 patients older than 60 years and diagnosed with depression or Alzheimer's disease (AD) are included. Cranial MRI, Mini Mental State Examination (MMSE), detailed neuropsychometric tests, and depression scales are applied to all patients. The SA, ventricular atrophy (VA), medial temporal lobe atrophy (MTA), periventricular WMH (PWMH), subcortical WMH (SCWMH), BGI, and ITI are scored according to the scale. The total score is also recorded.
The average age of the patients was 74.53, and the mean MMSE score was 22.7 in the degenerative group and 27.8 in the non-degenerative group. Among the patients, 50 were diagnosed with AD. All parameters significantly increased with age. In the degenerative group, SA, VA, MTA, PWMH, SCWMH, and total scores were found to be significantly higher. Sensitivities of VA, PWMH, SCWMH, and total scores, as well as both sensitivity and specificities of MTA score, were observed to be high. When they were combined, sensitivities and specificities were found to be high.
The scale is observed to be predictive in discriminating degenerative and non-degenerative processes. This discrimination is important, particularly in depressive patients complaining of forgetfulness.
随着认知能力随年龄增长而下降,脑沟回萎缩(SA)和脑室扩大也会增加。考虑到之前提出的视觉量表的测量结果,本研究提出了一种新的量表,可以同时评估脑萎缩、脑白质高信号(WMHs)、基底节梗死(BGI)和小脑梗死(ITI)。我们的目的是为临床医生提供一种实用且标准化的 MRI,以便在日常实践中使用。
共纳入 97 例年龄大于 60 岁且被诊断为抑郁症或阿尔茨海默病(AD)的患者。对所有患者进行颅脑 MRI、简易精神状态检查(MMSE)、详细神经心理测试和抑郁量表检查。根据量表对 SA、脑室萎缩(VA)、海马萎缩(MTA)、脑室周围 WMH(PWMH)、皮质下 WMH(SCWMH)、BGI 和 ITI 进行评分,并记录总评分。
患者的平均年龄为 74.53 岁,退行性组的 MMSE 平均评分为 22.7,非退行性组为 27.8。在患者中,有 50 人被诊断为 AD。所有参数均随年龄增长而显著增加。在退行性组中,SA、VA、MTA、PWMH、SCWMH 和总分明显升高。VA、PWMH、SCWMH 和总分的敏感性以及 MTA 评分的敏感性和特异性均较高。当它们结合使用时,敏感性和特异性都很高。
该量表在鉴别退行性和非退行性过程方面具有预测性。这种鉴别很重要,特别是在抱怨健忘的抑郁患者中。