脑白质高信号进展与遗忘型轻度认知障碍患者认知衰退的关系。
Association of White Matter Hyperintensity Progression with Cognitive Decline in Patients with Amnestic Mild Cognitive Impairment.
机构信息
Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
Department of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan.
出版信息
J Alzheimers Dis. 2021;80(2):877-883. doi: 10.3233/JAD-201451.
BACKGROUND
White matter hyperintensities (WMH) on MRI have been reported to increase the risk of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). However, effects of the progression of WMH on the cognition of patients with MCI remains unclear to date.
OBJECTIVE
To investigate the association between WMH progression and cognitive decline in amnestic MCI patients.
METHODS
Thirty-eight subjects with amnestic MCI were analyzed prospectively every year for 2 years. Fourteen MCI subjects dropped out on the final visit, and therefore 24 subjects with MCI were analyzed for the entire duration. The volumes of periventricular hyperintensities (PVH) and deep WMH (DWMH) were measured on T2 FLAIR using the 3D-slicer. The associations between PVH/DWMH progression and cognitive decline were investigated.
RESULTS
An increase in DWMH volume significantly correlated with changes in Mini-Mental State Examination and category verbal fluency scores, whereas an increase in PVH volume did not correlate with changes in any item.
CONCLUSION
DWMH progression was closely associated with a decline in frontal lobe function and semantic memory, suggesting that WMH progression might affect some AD pathophysiologies in amnestic MCI patients.
背景
磁共振成像（MRI）上的脑白质高信号（WMH）已被报道会增加从轻度认知障碍（MCI）向阿尔茨海默病（AD）转化的风险。然而，WMH 进展对 MCI 患者认知的影响迄今尚不清楚。
目的
研究 WM 进展与遗忘型 MCI 患者认知下降之间的关系。
方法
对 38 例遗忘型 MCI 患者进行前瞻性分析，每年一次，共 2 年。14 例 MCI 患者在最后一次随访时退出，因此对 24 例 MCI 患者进行了整个随访期的分析。使用 3D-slicer 在 T2 FLAIR 上测量脑室周围高信号（PVH）和深部脑白质高信号（DWMH）的体积。研究了 PVH/DWMH 进展与认知下降之间的关系。
结果
DWMH 体积的增加与简易精神状态检查和类别流畅性得分的变化显著相关，而 PVH 体积的增加与任何项目的变化均无相关性。
结论
DWMH 进展与额叶功能和语义记忆下降密切相关，这表明 WM 进展可能会影响遗忘型 MCI 患者的一些 AD 病理生理学。
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