在亚急性缺血性中风患者中，更大的深部白质高信号体积与更严重的社会行为变化相关。

Larger deep white matter hyperintensity volume correlates with more severe social behavioral changes in patients with subacute ischemic stroke.

作者信息

Qu Jian-Feng, Hu Hui-Hong, Liu Jian-Fei, Zhou Yue-Qiong, Cheng Wei-Yang, Shi Lin, Luo Yi-Shan, Zhao Lei, Chen Yang-Kun

机构信息

Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China.

Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China.

出版信息

Front Aging Neurosci. 2023 Nov 22;15:1259690. doi: 10.3389/fnagi.2023.1259690. eCollection 2023.

DOI:10.3389/fnagi.2023.1259690

PMID:38076539

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10702571/

Abstract

BACKGROUND

Changes in social behavior can occur after ischemic stroke. We aimed to investigate the potential correlations between neuroimaging variables and changes in social behavior in patients who experienced subacute ischemic stroke.

METHODS

We prospectively screened patients with first-ever ischemic stroke. Three months after the index stroke, changes in patients' social behavior were investigated by the Frontal Behavioral Inventory (FBI), which consists of both deficit and positive groups of behaviors. The protocol of brain magnetic resonance imaging (MRI) including the baseline MRI at the acute stage and additional MRI with three-dimensional T1-weighted imaging on follow-up. Using these MRI scans, we assessed the acute infarction and the volumes of various brain structures by an automatic volumetry tool.

RESULTS

Eighty patients were enrolled. In univariate analyses, patients with deficit behavioral changes had more left cortical infarction ( = 0.271, = 0.015), Cholinergic Pathways Hyperintensities Scale scores ( = 0.227, = 0.042), DWMH volumes ( = 0.349, = 0.001), and modified Rankin Scale (mRS) scores ( = 0.392, < 0.001). Patients with positive behavioral changes had more frequency of men ( = 0.229, = 0.041) and a history of hypertension ( = 0.245, = 0.028). In multiple stepwise linear regression models, after adjusting for age, deep WMH volumes ( = 0.849, 95% confidence interval = 0.352-1.346, = 0.001) and mRS scores on follow-up ( = 1.821, 95% confidence interval = 0.881-2.76, < 0.001) were significantly correlated with deficit behavioral changes ( = 0.245).

CONCLUSION

Larger deep WMH volumes and poorer mRS scores on follow-up were significantly correlated with deficit behavioral changes in patients with subacute ischemic stroke.

摘要

背景

缺血性中风后可能会出现社会行为的改变。我们旨在研究亚急性缺血性中风患者神经影像学变量与社会行为改变之间的潜在相关性。

方法

我们前瞻性地筛选首次发生缺血性中风的患者。在首次中风三个月后，通过额叶行为量表（FBI）对患者的社会行为变化进行调查，该量表包括行为缺陷组和积极行为组。脑部磁共振成像（MRI）方案包括急性期的基线MRI以及随访时的三维T1加权成像额外MRI。利用这些MRI扫描，我们通过自动容积测量工具评估急性梗死灶和各种脑结构的体积。

结果

共纳入80例患者。在单因素分析中，行为缺陷改变的患者有更多的左侧皮质梗死（=0.271，=0.015）、胆碱能通路高信号量表评分（=0.227，=0.042）、深部白质高信号（DWMH）体积（=0.349，=0.001）和改良Rankin量表（mRS）评分（=0.392，<0.001）。行为积极改变的患者男性比例更高（=0.229，=0.041）且有高血压病史（=0.245，=0.028）。在多步线性回归模型中，调整年龄后，深部WMH体积（=0.849，95%置信区间=0.352 - 1.346，=0.001）和随访时的mRS评分（=1.821，95%置信区间=0.881 - 2.76，<0.001）与行为缺陷改变显著相关（=0.245）。