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较高的全脑小血管疾病负担与轻度认知障碍及整体认知功能障碍相关:一项倾向评分匹配的病例对照研究。

Higher Total Cerebral Small Vessel Disease Burden Was Associated With Mild Cognitive Impairment and Overall Cognitive Dysfunction: A Propensity Score-Matched Case-Control Study.

作者信息

Li Xuanting, Yuan Junliang, Qin Wei, Yang Lei, Yang Shuna, Li Yue, Hu Wenli

机构信息

Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

NHC Key Laboratory of Mental Health, Peking University, Beijing, China.

出版信息

Front Aging Neurosci. 2021 Jul 12;13:695732. doi: 10.3389/fnagi.2021.695732. eCollection 2021.

Abstract

BACKGROUND AND OBJECTIVE

The combination of neuroimaging and cognition characteristics may provide complementary information for early identification of mild cognitive impairment (MCI). This study aimed to establish the clinical relevance between cerebral small vessel disease (CSVD) burden and MCI and further explored the cognitive characteristics linked to CSVD applying a propensity score matching (PSM) approach.

METHODS

The study was designed as a case-control study. All the subjects underwent the standard clinical assessments, neuropsychological testing battery (including global cognition, memory, executive function, and speed and motor control domains), and brain magnetic resonance imaging (MRI). A 1:2 nearest-neighbor matching approach without replacement was employed with a caliper of 0.15 in the PSM approach.

RESULTS

A total of 84 MCI patients and 186 cognitively normal controls were included in this study. After PSM, 74 MCI patients and 129 controls were successfully matched, and the covariate imbalance was well eliminated. Compared with controls, the MCI group had more severe CSVD burden. In the binary logistic regression analysis, CSVD was associated with MCI after adjusting for all confounders. The results of multivariate linear regression analyses showed that higher total MRI CSVD burden was related to the deficit of cognitive performance in global cognition and three important cognitive domains after adjusting for all confounders.

CONCLUSION

Cerebral small vessel disease was an independent risk factor of MCI. Moreover, higher total MRI CSVD burden was associated with the overall cognitive impairment among middle-aged and elderly Chinese adults.

摘要

背景与目的

神经影像学与认知特征的结合可为轻度认知障碍(MCI)的早期识别提供补充信息。本研究旨在建立脑小血管病(CSVD)负担与MCI之间的临床相关性,并采用倾向评分匹配(PSM)方法进一步探索与CSVD相关的认知特征。

方法

本研究设计为病例对照研究。所有受试者均接受标准临床评估、神经心理学测试组合(包括整体认知、记忆、执行功能以及速度和运动控制领域)和脑磁共振成像(MRI)。在PSM方法中采用1:2最近邻无放回匹配方法,卡尺为0.15。

结果

本研究共纳入84例MCI患者和186例认知正常对照。PSM后,成功匹配74例MCI患者和129例对照,协变量不平衡得到很好消除。与对照相比,MCI组CSVD负担更重。在二元逻辑回归分析中,调整所有混杂因素后,CSVD与MCI相关。多变量线性回归分析结果显示,调整所有混杂因素后,较高的MRI总体CSVD负担与整体认知及三个重要认知领域的认知表现缺陷相关。

结论

脑小血管病是MCI的独立危险因素。此外,较高的MRI总体CSVD负担与中国中老年成年人的整体认知障碍相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b867/8312094/7d36e241f5e9/fnagi-13-695732-g001.jpg

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