Shen Jun, Xu Ziwei, Liu Zhengxin, Duan Yu, Wei Wenshi, Chang Jie
Department of Neurology, Huadong Hospital of Fudan University, Shanghai 200040, China.
Department of Neurosurgery, Huadong Hospital of Fudan University, Shanghai 200040, China.
J Clin Med. 2023 Feb 1;12(3):1143. doi: 10.3390/jcm12031143.
White matter hyperintensities (WMH) caused by chronic cerebral hypoperfusion are common in Moyamoya disease (MMD) patients, but WMH burden with comprehensive cognition in adult asymptomatic MMD remains unknown. This study tried to investigate the association between the WMH burden and cognitive function in adult asymptomatic MMD. Sixty-four adult asymptomatic MMD patients without surgical revascularization were enrolled in this study and underwent a 3T MRI scan and complete cognitive tests from 2021 to 2022. WMH volume was extracted with brain anatomical analysis using the diffeomorphic deformation (BAAD) toolbox, which works on SPM 12 software. Multivariable linear regression analysis was performed to assess the association between WMH burden and cognitive function in asymptomatic MMD. Firstly, our data showed that lower education levels and higher WMH burden were strongly related to global cognitive impairment after adjusting for other variables. Secondly, WMH severity was significantly associated with several domains of neurocognitive function, including memory, semantic memory, and executive function. Finally, when stratified by sex, the female participants with WMH severity had lower cognitive performance in all areas than male participants. These results suggest that WMH burden was highly correlated with global cognition, memory, semantic memory, and executive function in asymptomatic MMD. Especially in female participants, the relationship became more evident.
慢性脑灌注不足所致的白质高信号（WMH）在烟雾病（MMD）患者中很常见，但成人无症状MMD患者的WMH负担与综合认知之间的关系尚不清楚。本研究试图探讨成人无症状MMD患者的WMH负担与认知功能之间的关联。本研究纳入了64例未接受手术血运重建的成人无症状MMD患者，并于2021年至2022年对其进行了3T磁共振成像（MRI）扫描及全面的认知测试。使用基于统计参数映射（SPM）12软件的同胚变形（BAAD）工具箱，通过脑解剖分析提取WMH体积。进行多变量线性回归分析，以评估无症状MMD患者的WMH负担与认知功能之间的关联。首先，我们的数据显示，在对其他变量进行校正后，较低的教育水平和较高的WMH负担与整体认知障碍密切相关。其次，WMH严重程度与神经认知功能的多个领域显著相关，包括记忆、语义记忆和执行功能。最后，按性别分层时，WMH严重程度较高的女性参与者在所有领域的认知表现均低于男性参与者。这些结果表明，在无症状MMD患者中，WMH负担与整体认知、记忆、语义记忆和执行功能高度相关。尤其是在女性参与者中，这种关系更为明显。
