Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea,
Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea,
Eur Neurol. 2021;84(4):280-287. doi: 10.1159/000515836. Epub 2021 Jun 2.
The irregular shapes of white matter hyperintensities (WMHs) are associated with poor cognitive function, diabetes, or lacunes. However, the association between the WMH shape and dementia remains understudied. We investigated the association between the calculated shape index of WMH and the diagnosis of dementia and cognitive function.
The inverse sphericity index (ISIWMH) and volume of WMHs (VOLWMH) were compared among 82 participants with normal cognition, 82 with Alzheimer's dementia (AD), and 82 with subcortical vascular dementia (SVD). We examined the associations of ISIWMH and VOLWMH with the modified Hachinski Ischemic Score (mHIS), diagnosis of AD and SVD, and cognitive test scores, using linear, multinomial, or hierarchical linear regression models.
The mHIS was associated with both ISIWMH (β = 0.326, p < 0.001) and VOLWMH (β = 0.299, p < 0.001). Both ISIWMH and VOLWMH were associated with the SVD diagnosis (odds ratio [OR] = 2.685, p = 0.002, ISIWMH; OR = 2.597, p = 0.005, VOLWMH), but not with AD. The SVD diagnosis was better explained when the multinomial regression model included both ISIWMH and VOLWMH instead of VOLWMH alone (χ2 = 20.768, df = 2, p < 0.001). The Trail Making Test-D (TMT-D) scores of the SVD patients were associated with both ISIWMH (β = 0.308) and VOLWMH (β = 0.293).
An irregular WMH shape may be associated with the high cerebrovascular component of cognitive impairment and the diagnosis and low cognitive flexibility of SVD, which may improve the prediction of SVD diagnosis when used in combination with WMH volume.
脑白质高信号（WMH）的不规则形状与认知功能下降、糖尿病或腔隙性脑梗死有关。然而，WMH 形状与痴呆之间的关系仍研究较少。我们研究了 WMH 计算形状指数与痴呆和认知功能诊断之间的关系。
比较 82 名认知正常者、82 名阿尔茨海默病（AD）患者和 82 名皮质下血管性痴呆（SVD）患者的反转球度指数（ISIWMH）和 WMH 体积（VOLWMH）。我们使用线性、多项或分层线性回归模型，检验 ISIWMH 和 VOLWMH 与改良哈钦斯基缺血量表（mHIS）、AD 和 SVD 诊断以及认知测试评分的关系。
mHIS 与 ISIWMH（β=0.326，p<0.001）和 VOLWMH（β=0.299，p<0.001）均相关。ISWMIH 和 VOLWMH 均与 SVD 诊断相关（优势比[OR]=2.685，p=0.002，ISIWMH；OR=2.597，p=0.005，VOLWMH），但与 AD 无关。当多项回归模型同时包含 ISIWMH 和 VOLWMH 而不是仅包含 VOLWMH 时，SVD 诊断的解释更好（χ2=20.768，df=2，p<0.001）。SVD 患者的连线测试-D（TMT-D）评分与 ISIWMH（β=0.308）和 VOLWMH（β=0.293）均相关。
WMH 形状不规则可能与认知障碍的高脑血管成分以及 SVD 的诊断和认知灵活性降低有关，当与 WMH 体积结合使用时，可能会提高 SVD 诊断的预测能力。
