Yamanaka Takehiko, Uchida Yuto, Sakurai Keita, Kato Daisuke, Mizuno Masayuki, Sato Toyohiro, Madokoro Yuta, Kondo Yuko, Suzuki Ayuko, Ueki Yoshino, Ishii Fumiyasu, Borlongan Cesar V, Matsukawa Noriyuki
1Department of Neurology.
4Department of Health Sciences, Nihon Fukushi University, Higashihaemi-chou, Aichi 475-0012, Japan.
Aging Dis. 2019 Aug 1;10(4):711-718. doi: 10.14336/AD.2018.0929. eCollection 2019 Aug.
Although several studies have demonstrated correlation between white matter hyperintensities (WMH) and impairment of executive functions, the underlying anatomical-functional relationships are not fully understood. The present study sought to investigate the correlations between the volume of WMH and medial temporal lobe atrophy (MTA) using quantitative magnetic resonance image (MRI) and a variety of executive function assessments. A total of 91 patients ranging in age from 58 to 90 years with mild cognitive impairment (MCI) due to Alzheimer's disease (AD) or early phase AD were recruited from the outpatient clinic at the Department of Neurology of Nagoya City University Hospital. We administered neuropsychological batteries evaluating verbal memory, orientation, spatial ability, sustained attention, and a variety of executive functions, including verbal fluency, flexibility, inhibition, and working memory. Quantitative MRI analyses were performed using Dr. View/Linux software and a voxel-based specific regional analysis system. Significant correlations were observed between WMH, as well as MTA, and some executive function scores. Regression analysis revealed that MTA was the strongest predictor of flexibility and verbal fluency. These findings provide new insight into the relationship between quantitative MRI analyses and various types of executive dysfunction in elderly people with MCI due to AD and/or early phase AD. When cognitive function is examined in elderly patients with MCI due to AD or early phase AD, it is important to consider the involvement of WMH and MTA, which is indicative of AD pathology in cognitive dysfunction, particularly executive function.
尽管多项研究已证明白质高信号（WMH）与执行功能损害之间存在关联，但潜在的解剖学-功能关系尚未完全明确。本研究旨在使用定量磁共振成像（MRI）和各种执行功能评估方法，探究WMH体积与内侧颞叶萎缩（MTA）之间的相关性。名古屋市立大学医院神经内科门诊共招募了91名年龄在58至90岁之间、因阿尔茨海默病（AD）或AD早期阶段而患有轻度认知障碍（MCI）的患者。我们进行了神经心理测试，评估言语记忆、定向、空间能力、持续注意力以及包括言语流畅性、灵活性、抑制和工作记忆在内的各种执行功能。使用Dr. View/Linux软件和基于体素的特定区域分析系统进行定量MRI分析。观察到WMH以及MTA与一些执行功能评分之间存在显著相关性。回归分析表明，MTA是灵活性和言语流畅性的最强预测因子。这些发现为定量MRI分析与因AD和/或AD早期阶段导致MCI的老年人各种类型执行功能障碍之间的关系提供了新的见解。在对因AD或AD早期阶段导致MCI的老年患者进行认知功能检查时，考虑WMH和MTA的影响非常重要，这表明AD病理学在认知功能障碍尤其是执行功能中发挥作用。
