Wong Fennie Choy Chin, Yatawara Chathuri, Low Audrey, Foo Heidi, Wong Benjamin Yi Xin, Lim Levinia, Wang Brian, Kumar Dilip, Ng Kok Pin, Kandiah Nagaendran
Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
University of Cambridge School of Clinical Medicine, Cambridge, UK.
Transl Stroke Res. 2021 Apr;12(2):284-292. doi: 10.1007/s12975-020-00847-4. Epub 2020 Sep 7.
To investigate patterns of hippocampal subfield atrophy among patients with amnestic mild cognitive impairment, stratified by severity of small vessel disease (SVD) and corresponding associations with cognitive domains. One hundred seventy-six MCI subjects (mean age = 65.56 years, SD = 8.77) underwent neuropsychological assessments and magnetic resonance imaging. SVD was rated 0 (no SVD), 1 (mild SVD) and 2 (moderate to severe SVD) based on load of white matter hyperintensities (WMH) and lacunes. Demographics, cerebrovascular risk factors, grey and white matter volumes and hippocampal subfield atrophies were compared across SVD severity through ANCOVA analyses. Subjects were categorized into positive or negative SVD-hippocampal subfield atrophy (HSA) and influence of positive SVD-HSA on episodic memory and frontal executive function was evaluated through ANCOVA analyses. All analyses corrected for covariates and bias-corrected bootstrap estimation with 1000 resamples was applied with Bonferroni correction. Hippocampal subfield atrophy worsened with increasing SVD severity. Positive SVD-HSA was characterised by significant atrophy in the subiculum, CA1, CA4, molecular layer and dentate gyrus. Greater atrophy was seen with moderate to severe SVD compared to mild SVD in these subfields. Atrophy in the five subfields of SVD-HSA was significantly associated with poor episodic memory and frontal executive function. Presence and burden of SVD influences the pattern and severity of hippocampal subfield atrophy. SVD-related hippocampal subfield atrophy is associated with poorer episodic memory and frontal executive function in mild cognitive impairment.
为了研究遗忘型轻度认知障碍患者海马亚区萎缩的模式，按小血管病（SVD）严重程度分层，并研究其与认知领域的相应关联。176名轻度认知障碍受试者（平均年龄 = 65.56岁，标准差 = 8.77）接受了神经心理学评估和磁共振成像检查。根据白质高信号（WMH）和腔隙负荷，将SVD分为0级（无SVD）、1级（轻度SVD）和2级（中度至重度SVD）。通过协方差分析比较不同SVD严重程度下的人口统计学、脑血管危险因素、灰质和白质体积以及海马亚区萎缩情况。将受试者分为SVD-海马亚区萎缩（HSA）阳性或阴性，并通过协方差分析评估阳性SVD-HSA对情景记忆和额叶执行功能的影响。所有分析均对协变量进行了校正，并应用了1000次重采样的偏差校正自助估计和Bonferroni校正。海马亚区萎缩随着SVD严重程度的增加而加重。阳性SVD-HSA的特征是下托、CA1、CA4、分子层和齿状回显著萎缩。与轻度SVD相比，这些亚区在中度至重度SVD时萎缩更明显。SVD-HSA五个亚区的萎缩与情景记忆差和额叶执行功能显著相关。SVD的存在和负担会影响海马亚区萎缩的模式和严重程度。在轻度认知障碍中，与SVD相关的海马亚区萎缩与较差的情景记忆和额叶执行功能有关。
