Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada.
Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada.
Neurobiol Aging. 2019 May;77:183-193. doi: 10.1016/j.neurobiolaging.2018.12.011. Epub 2019 Jan 5.
Some degree of ischemic injury to white matter tracts occurs naturally with age and is visible on magnetic resonance imaging as focal or confluent white matter hyperintensities. Its relationship to cognition, however, remains unclear. To explore this, community-dwelling adults between the ages 55 and 80 years completed structural imaging, neuropsychological testing, and questionnaires to provide objective measures and subjective experience of executive functioning. Volumetric lesion burden derived from structural MRI identified those with significant white matter hyperintensity burden (∼10 cm). Half of those recruited met this criterion and were designated as the cerebral small vessel disease (CSVD) group. Subjective cognitive complaints but not objective test scores differentiated adults with and without CSVD. Hierarchical clustering revealed 2 CSVD subgroups that differentiated those with impaired versus preserved executive function relative to controls. Overall these results provide some explanation for behavioral heterogeneity often observed in studies of age-related white matter changes. They also support the use of questionnaires to assess subjective cognitive complaints that may point to subtle effects of vascular pathology not evident on standardized cognitive scores.
随着年龄的增长，某些程度的白质束缺血性损伤是自然发生的，在磁共振成像上可见为局灶性或融合性的白质高信号。然而，其与认知的关系尚不清楚。为了探讨这一点，年龄在 55 岁至 80 岁之间的社区居住成年人完成了结构成像、神经心理学测试和问卷调查，以提供执行功能的客观测量和主观体验。从结构 MRI 中得出的容积病变负担确定了那些有明显白质高信号负担（约 10 cm）的人。招募的一半人符合这一标准，被指定为脑小血管疾病（CSVD）组。主观认知主诉而不是客观测试分数区分了有和没有 CSVD 的成年人。层次聚类揭示了 2 个 CSVD 亚组，这些亚组区分了与对照组相比执行功能受损和保留的人。总的来说，这些结果为年龄相关的白质变化研究中经常观察到的行为异质性提供了一些解释。它们还支持使用问卷调查来评估主观认知主诉，这些主诉可能指向在标准化认知评分上不明显的血管病理的微妙影响。
