Li Xudong, Shen Miaoxin, Jin Yi, Jia Shuhong, Zhou Zhi, Han Ziling, Zhang Xiangfei, Tong Xiaopeng, Jiao Jinsong
Department of Cognitive Disorder, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Psychiatry. 2021 Jul 16;12:685965. doi: 10.3389/fpsyt.2021.685965. eCollection 2021.
Cerebral small vessel disease (CSVD) is the most common vascular cause of dementia, and mild cognitive impairment (MCI) is an intermediate state between dementia and normal cognitive aging. The present study investigated the main imaging features of CSVD on different MCI subtypes in memory clinics. A total of 236 patients with MCI and 85 healthy controls were included. One hundred nine amnestic MCI-multiple domains (amMCI), 38 amnestic MCI-single domain (asMCI), 36 non-amnestic MCI-multiple domains (namMCI), and 53 non-amnestic MCI-single domain (nasMCI) patients were diagnosed. All participants were evaluated with the cognitive assessments and imaging features including white matter hyperintensity (WMH), enlarged perivascular spaces (EPVS), cerebral microbleeds (CMBs), and cerebral atrophy according to a standard procedure. The patients with amMCI, namMCI, and nasMCI had more high-grade basal ganglia EPVS compared with healthy controls, while the percentages of high-grade basal ganglia EPVS in the patients with amMCI were also more than those in patients with asMCI, namMCI, and nasMCI. There were more high-grade centrum semiovale EPVS in patients with amMCI in comparison with all other groups. The patients with amMCI and namMCI had more percentages of severe deep and periventricular WMH and deep CMBs compared with healthy controls. All MCI groups had higher scores of the medial temporal lobe atrophy than healthy controls, whereas the scores of the amMCI group were also higher than those of the namMCI and nasMCI groups. There were varied neuroimaging features of CSVD including cerebral atrophy in different MCI groups, which meant that vascular mechanism contributed to the prodromal stage of dementia.
脑小血管病（CSVD）是痴呆最常见的血管性病因，而轻度认知障碍（MCI）是痴呆与正常认知老化之间的中间状态。本研究调查了记忆门诊中不同MCI亚型的CSVD主要影像学特征。共纳入236例MCI患者和85例健康对照。诊断出109例遗忘型MCI-多领域（amMCI）、38例遗忘型MCI-单领域（asMCI）、36例非遗忘型MCI-多领域（namMCI）和53例非遗忘型MCI-单领域（nasMCI）患者。所有参与者均按照标准程序进行认知评估和影像学特征评估，包括白质高信号（WMH）、血管周围间隙扩大（EPVS）、脑微出血（CMB）和脑萎缩。与健康对照相比，amMCI、namMCI和nasMCI患者的基底节高级别EPVS更多，而amMCI患者的基底节高级别EPVS百分比也高于asMCI、namMCI和nasMCI患者。与所有其他组相比，amMCI患者的半卵圆中心高级别EPVS更多。与健康对照相比，amMCI和namMCI患者的深部和脑室周围严重WMH及深部CMB百分比更高。所有MCI组的内侧颞叶萎缩评分均高于健康对照，而amMCI组的评分也高于namMCI和nasMCI组。不同MCI组的CSVD存在多种神经影像学特征，包括脑萎缩，这意味着血管机制在痴呆前驱期起作用。
