Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Curr Neurovasc Res. 2019;16(2):107-114. doi: 10.2174/1567202616666190227202638.
Lacunes and white matter hyperintensities (WMH) are two common findings seen on neuroimaging in patients with cerebral small vessel disease (cSVD). Clinically we observed that some patients with cSVD have aphasia through the language assessment scale. Our study aimed to explore the underlying risk factors for aphasia in cSVD patients.
This study retrospectively analyzed 38 patients, with and without aphasia, aged 50 or over, Chinese Han population, diagnosed as cSVD with lacunes and/or WMH. We collected demographic characteristics and vascular risk factors. The severity of WMH was assessed by the age related white matter changes (ARWMC) rating scale.
Risk factors associated with aphasia were: lower education (p = 0.029), higher total cholesterol (TC) levels (p = 0.023), and higher low-density lipoprotein cholesterol (LDL-C) levels (p = 0.027). After controlling for age and sex, levels of TC (odds ratios, 1.96; 95% confidence interval, 1.06-3.62; p = 0.032) remained associated with aphasia independently.
High level of TC was significantly associated with a higher risk of aphasia in clinically silent cSVD patients. Early interventions including lipid-lowering treatment, cranial magnetic resonance imaging (MRI) and ARWMC rating scale should be performed. Further studies are needed to explore proper methods of prevention and treatment for aphasia in clinically silent cSVD patients, in addition to understanding the pathophysiological mechanism.
腔隙性病变和脑白质高信号（WMH）是脑小血管病（cSVD）患者神经影像学检查中的两种常见表现。临床上我们发现，一些 cSVD 患者通过语言评估量表表现出失语症。本研究旨在探讨 cSVD 患者失语症的潜在危险因素。
本研究回顾性分析了 38 例年龄在 50 岁及以上的汉族腔隙性病变和/或脑白质高信号的 cSVD 患者，其中有无失语症。收集人口统计学特征和血管危险因素。WMH 的严重程度采用年龄相关性脑白质改变（ARWMC）评分量表进行评估。
与失语症相关的危险因素有：受教育程度较低（p = 0.029）、总胆固醇（TC）水平较高（p = 0.023）和低密度脂蛋白胆固醇（LDL-C）水平较高（p = 0.027）。在校正年龄和性别后，TC 水平（比值比，1.96；95%置信区间，1.06-3.62；p = 0.032）仍与失语症独立相关。
TC 水平升高与临床无症状 cSVD 患者发生失语症的风险显著相关。应进行早期干预，包括降脂治疗、头颅磁共振成像（MRI）和 ARWMC 评分。需要进一步研究以探索针对临床无症状 cSVD 患者失语症的预防和治疗方法，并深入了解其病理生理机制。
