Lin Chia-Yen, Jhan Song-Ru, Lee Wei-Ju, Chen Po-Lin, Chen Jun-Peng, Chen Hung-Chieh, Chen Ting-Bin
Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Neuroradiology, Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
Front Neurol. 2021 Nov 12;12:747536. doi: 10.3389/fneur.2021.747536. eCollection 2021.
Small vessel disease (SVD) imaging markers are related to ischemic and hemorrhage stroke and to cognitive dysfunction. This study aimed to clarify the relationship between SVD imaging markers and subcortical vascular dementia in severe SVD burden. A total of 57 subjects with multiple lobar cerebral microbleeds (CMBs) and four established SVD imaging markers were enrolled from the dementia and stroke registries of a single center. Visual rating scales that are used to semi-quantify SVD imaging changes were analyzed individually and compositely to make correlations with cognitive domains and subcortical vascular dementia. Dementia group had higher subcortical and total white matter hyperintensities (WMHs) and SVD composite scores than non-dementia group. Individual imaging markers correlated differently with one another and had distinct cognitive correlations. After adjusting for demographic factors, multivariate logistic regression indicated associations of subcortical WMHs (odds ratio [OR] 2.03, CI 1.24-3.32), total WMHs (OR 1.43, CI 1.09-1.89), lacunes (OR 1.18, CI 1.02-1.35), cerebral amyloid angiopathy-SVD scores (OR 2.33, CI 1.01-5.40), C scores (imaging composite scores of CMB and WMH) (OR 1.41, CI 1.09-1.83), and C scores (imaging composite scores of CMB, WMH, perivascular space, and lacune) (OR 1.38, CI 1.08-1.76) with dementia. SVD imaging markers might have differing associations with cognitive domains and dementia. They may provide valuable complementary information in support of personalized treatment planning against cognitive impairment, particularly in patients with a heavy SVD load.
小血管疾病（SVD）成像标志物与缺血性和出血性中风以及认知功能障碍有关。本研究旨在阐明在严重SVD负担情况下SVD成像标志物与皮质下血管性痴呆之间的关系。从单一中心的痴呆和中风登记处招募了总共57名患有多个脑叶脑微出血（CMB）且具有四种已确定的SVD成像标志物的受试者。对用于半定量SVD成像变化的视觉评分量表进行单独和综合分析，以使其与认知领域和皮质下血管性痴呆相关联。痴呆组的皮质下和总白质高信号（WMH）以及SVD综合评分高于非痴呆组。各个成像标志物之间的相关性不同，并且具有不同的认知相关性。在调整人口统计学因素后，多因素逻辑回归表明皮质下WMH（比值比[OR] 2.03，CI 1.24 - 3.32）、总WMH（OR 1.43，CI 1.09 - 1.89）、腔隙（OR 1.18，CI 1.02 - 1.35）、脑淀粉样血管病 - SVD评分（OR 2.33，CI 1.01 - 5.40）、C评分（CMB和WMH的成像综合评分）（OR 1.41，CI 1.09 - 1.83）以及C评分（CMB、WMH、血管周围间隙和腔隙的成像综合评分）（OR 1.38，CI 1.08 - 1.76）与痴呆相关。SVD成像标志物可能与认知领域和痴呆有不同的关联。它们可能提供有价值的补充信息，以支持针对认知障碍的个性化治疗计划，特别是在SVD负荷较重的患者中。
