Kuroda Takeshi, Honma Motoyasu, Mori Yukiko, Futamura Akinori, Sugimoto Azusa, Yano Satoshi, Kinno Ryuta, Murakami Hidetomo, Ono Kenjiro
Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
Department of Physiology, Showa University School of Medicine, Tokyo, Japan.
Front Aging Neurosci. 2020 Jan 31;12:13. doi: 10.3389/fnagi.2020.00013. eCollection 2020.
: To investigate whether the number of cerebral microbleeds (CMB) could be a useful indicator to predict glymphatic system dysfunction in Alzheimer's disease (AD) patients, by comparing the degree of cerebral spinal fluid (CSF) and interstitial fluid (ISF) stasis. : Forty probable AD patients were included, with those exhibiting two or more CMB were included in the multiple CMB group (mCMB, = 21, mean = 11.1), and none or one CMB included in the non-multiple CMB group (nmCMB, = 19, mean = 0.84). CMB was defined in axial gradient recalled echo (GRE) T2*-weighted images. Evans index (EI) was calculated to measure lateral ventricle enlargement, Voxel-based Specific Regional Analysis System for Alzheimer's Disease (VSRAD) software was used to determine the extent of gray and white matter atrophy, and Fazekas scale (FS) was used to determine white matter hyperintensities (WMH). : EI was significantly larger in mCMB than in nmCMB, while the gray and white matter volume was not different between groups. Thus, the difference in lateral ventricle enlargement between AD with and without multiple CMB reflects a combination of the degree of brain atrophy and the extent of CSF stasis. FS was higher in mCMB than in the nmCMB, suggesting the failure of ISF elimination was more severe in mCMB cases. : The difference in lateral ventricle enlargement and WMH between AD with or without multiple CMB may reflect a difference in the degree of CSF/ISF stagnation.
为了通过比较脑脊液（CSF）和组织间液（ISF）的淤滞程度，研究脑微出血（CMB）的数量是否可作为预测阿尔茨海默病（AD）患者脑淋巴系统功能障碍的有用指标。纳入40例可能患有AD的患者，其中有两个或更多CMB的患者被纳入多CMB组（mCMB，n = 21，平均值 = 11.1），无或仅有一个CMB的患者被纳入非多CMB组（nmCMB，n = 19，平均值 = 0.84）。在轴向梯度回波（GRE）T2*加权图像中定义CMB。计算埃文斯指数（EI）以测量侧脑室扩大情况，使用基于体素的阿尔茨海默病特异性区域分析系统（VSRAD）软件确定灰质和白质萎缩程度，并使用法泽卡斯量表（FS）确定白质高信号（WMH）。mCMB组的EI显著大于nmCMB组，而两组之间的灰质和白质体积无差异。因此，有和没有多个CMB的AD患者在侧脑室扩大方面的差异反映了脑萎缩程度和CSF淤滞程度的综合情况。mCMB组的FS高于nmCMB组，表明mCMB病例中ISF清除失败更为严重。有或没有多个CMB的AD患者在侧脑室扩大和WMH方面的差异可能反映了CSF/ISF停滞程度的差异。
