Liu Xiao-Jiao, Che Ping, Xing Mengya, Tian Xiao-Bing, Gao Chunli, Li Xiuyan, Zhang Nan
Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China.
Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
Front Aging Neurosci. 2021 Nov 22;13:741881. doi: 10.3389/fnagi.2021.741881. eCollection 2021.
A growing body of evidence indicates that atherosclerosis is correlated with cerebral small vessel disease and contributes to cognitive decline. This study aimed to explore the characteristics and contributions of intracranial hemodynamics and carotid atherosclerosis to cognitive dysfunction in subjects with subcortical ischemic vascular dementia (SIVD). Notably, 44 patients with SIVD, 30 patients with Alzheimer's disease (AD), and 30 healthy controls (HCs) were recruited from our longitudinal MRI study for AD and SIVD (ChiCTR1900027943). The cerebral mean flow velocity (MFV) and pulsatility index (PI) of both anterior and posterior circulations, artery plaque, and lumen diameter in carotid arteries were investigated using transcranial Doppler and carotid ultrasound, respectively. Their correlations with cognitive function were analyzed in patients with dementia. Decreased MFV and increased PI were found in patients with SIVD and AD. Patients with SIVD showed lower MFV and higher PI in the bilateral posterior cerebral arteries compared to patients with AD. Increases in lumen diameter, number of arteries with plaque, and total carotid plaque score were found in patients with SIVD. The Mini-Mental State Examination score was positively correlated with the MFV and negatively correlated with the PI of most major cerebral arteries, while it was negatively correlated with the lumen diameter of the common carotid artery, number of arteries with plaque, and total carotid plaque score in patients with dementia. There were also correlations between these parameters of some arteries and memory and executive function. Our results provide additional evidence suggesting that the pathological changes in macrovascular structure and function are correlated with cognitive impairment in dementia patients with SIVD and to a lesser extent AD.
越来越多的证据表明，动脉粥样硬化与脑小血管疾病相关，并导致认知功能下降。本研究旨在探讨颅内血流动力学和颈动脉粥样硬化对皮质下缺血性血管性痴呆（SIVD）患者认知功能障碍的特征及影响。值得注意的是，我们从针对AD和SIVD的纵向MRI研究（ChiCTR1900027943）中招募了44例SIVD患者、30例阿尔茨海默病（AD）患者和30名健康对照者（HCs）。分别使用经颅多普勒和颈动脉超声研究了前后循环的脑平均血流速度（MFV）和搏动指数（PI）、动脉斑块以及颈动脉的管腔直径。分析了痴呆患者中这些指标与认知功能的相关性。在SIVD和AD患者中发现MFV降低和PI升高。与AD患者相比，SIVD患者双侧大脑后动脉的MFV更低，PI更高。SIVD患者的管腔直径、有斑块的动脉数量和颈动脉斑块总分均增加。简易精神状态检查表评分与大多数主要脑动脉的MFV呈正相关，与PI呈负相关，而在痴呆患者中，它与颈总动脉的管腔直径、有斑块的动脉数量和颈动脉斑块总分呈负相关。一些动脉的这些参数与记忆和执行功能之间也存在相关性。我们的结果提供了更多证据，表明大血管结构和功能的病理变化与SIVD痴呆患者以及程度较轻的AD患者的认知障碍相关。
