Mykola Petrenko, Svyrydova Natalia, Trufanov Yevgen
Department of Neurology and Reflexotherapy, P.L. Shupyk National Medical Academy of Postgraduate Education, 9 Dorohozhytska Str, Kyiv, 04112, Ukraine.
Neurol Sci. 2020 Oct;41(10):2853-2858. doi: 10.1007/s10072-020-04414-5. Epub 2020 Apr 22.
Cerebral small vessel disease (SVD) is a common accompaniment to aging. Magnetic resonance imaging (MRI) features of SVD include lacunar infarcts (LI) and white matter hyperintensity (WMH). Brain iron deposition is also a known marker of SVD that is associated with cognitive impairment and can be detected with susceptibility-weighted imaging (SWI) MRI technique. According to recent studies, the pulsation of cerebral blood flow can be one of the main factors of the development of pathological brain changes in elderly patients. The objective of this study was to investigate the relationship between the brain iron deposition, cerebral blood flow pulsation, and cognitive impairment in patients with SVD.
For the study, 97 patients with diagnosed SVD were selected. The patients were divided into two groups based on the Montreal Cognitive Assessment (MoCA) test scores. All patients underwent MRI in the SWI sequence. Pulsatility index (PI) and resistivity index (RI) were recorded from the middle cerebral artery bilaterally using transcranial Doppler (TCD).
The linear regression model showed that the pulsatility index (PI) and resistivity index (RI) were associated with cognitive impairment and brain iron deposition in basal ganglia. The most significant association was found between left globus pallidus severe hypointensity voxels count and left middle cerebral artery (MCA) RI (p = 0.009).
The results of the study provide information that TCD indicators may be associated with brain iron deposition and cognitive decline in patients with SVD. Our findings suggest that both brain iron deposition and cerebral hemodynamics abnormalities may play an important role in the pathophysiological mechanisms of SVD.
脑小血管病（SVD）是衰老常见的伴随病症。SVD的磁共振成像（MRI）特征包括腔隙性梗死（LI）和白质高信号（WMH）。脑铁沉积也是SVD的一个已知标志物，与认知障碍相关，可通过磁敏感加权成像（SWI）MRI技术检测到。根据最近的研究，脑血流搏动可能是老年患者病理性脑变化发展的主要因素之一。本研究的目的是探讨SVD患者脑铁沉积、脑血流搏动与认知障碍之间的关系。
本研究选取了97例已确诊SVD的患者。根据蒙特利尔认知评估（MoCA）测试分数将患者分为两组。所有患者均接受SWI序列的MRI检查。使用经颅多普勒（TCD）从双侧大脑中动脉记录搏动指数（PI）和阻力指数（RI）。
线性回归模型显示，搏动指数（PI）和阻力指数（RI）与认知障碍及基底节区脑铁沉积相关。在左侧苍白球严重低信号体素计数与左侧大脑中动脉（MCA）RI之间发现了最显著的关联（p = 0.009）。
该研究结果表明，TCD指标可能与SVD患者的脑铁沉积和认知衰退相关。我们的研究结果表明，脑铁沉积和脑血流动力学异常可能在SVD的病理生理机制中起重要作用。
