Li Ren-Ren, He Yu-Sheng, Liu Meng, Nie Zhi-Yu, Huang Li-He, Lu Zheng, Jin Ling-Jing, Li Yun-Xia
Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China.
School of Foreign Languages, Research Center for Ageing, Language and Care, Tongji University, Shanghai 200092, People's Republic of China.
Neuropsychiatr Dis Treat. 2019 Sep 18;15:2705-2714. doi: 10.2147/NDT.S207069. eCollection 2019.
This study aimed to characterize white matter lesions (WMLs) and regional cerebral perfusion, and evaluate their correlations with cognitive deficits in Alzheimer's disease (AD) patients.
One hundred and twenty-eight patients with AD (AD group) and 75 subjects without AD (control group) were recruited. The medical information was collected from each subject. Montreal cognitive assessment (MoCA) was employed for the assessment of cognition. Cranial MRI was performed, and the KIM scoring system was used to evaluate the white matter hyperintensity. The CT perfusion (CTP) imaging was employed to assess the whole cerebral perfusion, and the region of interest (ROI) was selected to determine the blood perfusion at different parts.
The education level and MoCA score in AD group were significantly lower than in control group (<0.001). The KIM score of juxtaventricular WML (JVWMLs) was significantly different between two groups (<0.05) and AD group showed a higher incidence of severe JVWML and periventricular WML (PVWMLs); in AD group, the total KIM score and KIM scores of JVWMLs, PVWMLs and deep WML (DWMLs) showed negative relationships with the MoCA score (<0.001). As compared to control group, the blood perfusion of either whole brain or different parts in the AD group reduced significantly (<0.05). In the AD group, there was a negative correlations of blood perfusion at JVWM and PVWM with corresponding KIM scores (<0.05 or 0.01). In the AD group, the blood perfusions of the whole brain, JVWMLs, PVWMLs and deep WML were negatively related to MoCA score (<0.05).
In conclusion, the cognitive deficits in the AD patients are associated with the degree of WMLs, especially the JVWML, PVWML and DWML as well as with the reduced perfusion of JVWM, PVWM and deep WM.
本研究旨在描述白质病变（WMLs）和局部脑灌注情况，并评估它们与阿尔茨海默病（AD）患者认知缺陷的相关性。
招募了128例AD患者（AD组）和75例非AD受试者（对照组）。收集了每位受试者的医学信息。采用蒙特利尔认知评估（MoCA）对认知进行评估。进行了头颅MRI检查，并使用KIM评分系统评估白质高信号。采用CT灌注（CTP）成像评估全脑灌注，并选择感兴趣区（ROI）确定不同部位的血流灌注。
AD组的受教育程度和MoCA评分显著低于对照组（<0.001）。两组间脑室旁白质病变（JVWMLs）的KIM评分有显著差异（<0.05），AD组严重JVWML和脑室周围白质病变（PVWMLs）的发生率更高；在AD组中，总KIM评分以及JVWMLs、PVWMLs和深部白质病变（DWMLs）的KIM评分与MoCA评分呈负相关（<0.001）。与对照组相比，AD组全脑及不同部位的血流灌注均显著降低（<0.05）。在AD组中，JVWM和PVWM处的血流灌注与相应的KIM评分呈负相关（<0.05或0.01）。在AD组中，全脑、JVWMLs、PVWMLs和深部白质的血流灌注与MoCA评分呈负相关（<0.05）。
总之，AD患者的认知缺陷与WMLs的程度相关，尤其是JVWML、PVWML和DWML，也与JVWM、PVWM和深部白质的灌注减少有关。
