Hannan Jade, Busby Natalie, Roth Rebecca, Wilmskoetter Janina, Newman-Norlund Roger, Rorden Chris, Bonilha Leonardo, Fridriksson Julius
Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA.
Department of Neurology, Emory University, Atlanta, GA 30322, USA.
Brain Commun. 2024 Jun 11;6(3):fcae200. doi: 10.1093/braincomms/fcae200. eCollection 2024.
While converging research suggests that increased white matter hyperintensity load is associated with poorer cognition, and the presence of hypertension is associated with increased white matter hyperintensity load, the relationship among hypertension, cognition and white matter hyperintensities is not well understood. We sought to determine the effect of white matter hyperintensity burden on the relationship between hypertension and cognition in individuals with post-stroke aphasia, with the hypothesis that white matter hyperintensity load moderates the relationship between history of hypertension and cognitive function. Health history, Fazekas scores for white matter hyperintensities and Wechsler Adult Intelligence Scale Matrix Reasoning subtest scores for 79 people with aphasia collected as part of the Predicting Outcomes of Language Rehabilitation study at the Center for the Study of Aphasia Recovery at the University of South Carolina and the Medical University of South Carolina were analysed retrospectively. We found that participants with a history of hypertension had increased deep white matter hyperintensity severity ( < 0.001), but not periventricular white matter hyperintensity severity ( = 0.116). Moderation analysis revealed that deep white matter hyperintensity load moderates the relationship between high blood pressure and Wechsler Adult Intelligence Scale scores when controlling for age, education, aphasia severity and lesion volume. The interaction is significant, showing that a history of high blood pressure and severe deep white matter hyperintensities together are associated with poorer Matrix Reasoning scores. The overall model explains 41.85% of the overall variation in Matrix Reasoning score in this group of participants. These findings underscore the importance of considering cardiovascular risk factors in aphasia treatment, specifically hypertension and its relationship to brain health in post-stroke cognitive function.
虽然越来越多的研究表明，白质高信号负荷增加与认知能力下降有关，而高血压的存在与白质高信号负荷增加有关，但高血压、认知与白质高信号之间的关系尚未完全明确。我们试图确定白质高信号负担对中风后失语症患者高血压与认知关系的影响，假设白质高信号负荷会调节高血压病史与认知功能之间的关系。对南卡罗来纳大学失语症康复研究中心和南卡罗来纳医科大学收集的79名失语症患者的健康史、白质高信号的 Fazekas 评分以及韦氏成人智力量表矩阵推理子测验分数进行了回顾性分析。我们发现，有高血压病史的参与者深部白质高信号严重程度增加（<0.001），但脑室周围白质高信号严重程度未增加（=0.116）。调节分析显示，在控制年龄、教育程度、失语严重程度和病变体积时，深部白质高信号负荷调节高血压与韦氏成人智力量表分数之间的关系。这种相互作用是显著的，表明高血压病史和严重的深部白质高信号共同与较差的矩阵推理分数相关。总体模型解释了该组参与者矩阵推理分数总体变异的41.85%。这些发现强调了在失语症治疗中考虑心血管危险因素的重要性，特别是高血压及其与中风后认知功能中脑健康的关系。
