Wang Peijiong, Cai Husule, Luo Rutao, Zhang Zihao, Zhang Dong, Zhang Yan
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
Front Aging Neurosci. 2021 Jul 5;13:620763. doi: 10.3389/fnagi.2021.620763. eCollection 2021.
Severe carotid artery stenosis (CAS) can lead to atrophy of gray matter (GM) and memory impairment; however, the underlying mechanism is unknown. Thus, we aimed to identify memory impairment and GM atrophy and explore the possible correlation between them in patients with asymptomatic severe CAS.
Twenty-four patients with asymptomatic severe CAS and 10 healthy controls completed the mini-mental state examination (MMSE) and clinical memory scale (CMS) and underwent 7T magnetic resonance imaging (MRI) scan. Field intensity inhomogeneities were corrected. Images were processed using VBM8, and GM images were flipped. First, 11 flipped and 10 non-flipped images of patients with unilateral CAS and 5 flipped and 5 non-flipped images of controls were pre-processed using DARTEL algorithm and analyzed using an analysis of variance (ANOVA). Second, flipped and non-flipped images of unilateral patients were similarly pre-processed and analyzed using the paired -test. Third, pre-processed non-flipped GM images and CMS scores of 24 patients were analyzed by multiple regression analysis. Nuisance variables were corrected accordingly.
Basic information was well matched between patients and controls. MMSE scores of patients were in the normal range; however, memory function was significantly reduced (all < 0.05). GM volumes of patients were significantly reduced in the anterior circulation regions. The stenosis-side hemispheres showed greater atrophy. GM volumes of the left pars opercularis, pars triangularis, and middle frontal gyrus were strongly positively correlated with the total scores of CMS (all > 0.7, = 0.001). Additionally, the left middle frontal gyrus was strongly positively correlated with associative memory ( = 0.853, = 0.001). The left pars opercularis was moderately positively correlated with semantic memory ( = 0.695, = 0.001).
Patients with asymptomatic CAS suffer from memory impairment. Bilateral anterior circulation regions showed extensive atrophy. The hemisphere with stenosis showed severer atrophy. Memory impairment in patients may be related to atrophy of the left frontal gyrus and atrophy of different regions may result in different memory impairments.
重度颈动脉狭窄（CAS）可导致灰质（GM）萎缩和记忆障碍；然而，其潜在机制尚不清楚。因此，我们旨在识别无症状重度CAS患者的记忆障碍和GM萎缩，并探讨它们之间可能的相关性。
24例无症状重度CAS患者和10名健康对照者完成简易精神状态检查表（MMSE）和临床记忆量表（CMS），并接受7T磁共振成像（MRI）扫描。校正场强不均匀性。使用VBM8处理图像，并翻转GM图像。首先，对单侧CAS患者的11张翻转图像和10张未翻转图像以及对照者的5张翻转图像和5张未翻转图像使用DARTEL算法进行预处理，并采用方差分析（ANOVA）进行分析。其次，对单侧患者的翻转图像和未翻转图像进行类似的预处理，并采用配对检验进行分析。第三，通过多元回归分析对24例患者预处理后的未翻转GM图像和CMS评分进行分析。相应地校正干扰变量。
患者与对照者的基本信息匹配良好。患者的MMSE评分在正常范围内；然而，记忆功能显著降低（均P<0.05）。患者在前循环区域的GM体积显著减小。狭窄侧半球萎缩更明显。左侧岛盖部、三角部和额中回的GM体积与CMS总分呈强正相关（均r>0.7，P = 0.001）。此外，左侧额中回与联想记忆呈强正相关（r = 0.853，P = 0.001）。左侧岛盖部与语义记忆呈中度正相关（r = 0.695，P = 0.001）。
无症状CAS患者存在记忆障碍。双侧前循环区域出现广泛萎缩。狭窄侧半球萎缩更严重。患者的记忆障碍可能与左侧额回萎缩有关，不同区域的萎缩可能导致不同的记忆障碍。
