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磁共振扩散张量成像用于检测脑小血管病所致轻度认知障碍患者的脑微观结构变化。

Magnetic resonance diffusion tensor imaging for detecting the cerebral microstructure changes in patients with CSVD-induced mild cognitive impairment.

作者信息

Xu Jing, Zhong Hongyan, Wu Liuyang

机构信息

Department of Radiology, Jiangnan University Medical Center, Wuxi, People's Republic of China.

Department of Neurology, Huai'an Cancer Hospital, Huai'an, People's Republic of China.

出版信息

J Neurophysiol. 2024 Dec 1;132(6):1937-1942. doi: 10.1152/jn.00408.2024. Epub 2024 Nov 6.

Abstract

Cerebral small vessel disease (CSVD)-induced mild cognitive impairment (MCI) has been linked to cognitive decline. Brain atrophy is considered the most common change in patients with MCI, which can be measured by diffusion tensor imaging (DTI). The study aimed to explore the relationship between DTI parameters and cognitive function in CSVD patients with MCI. This retrospective analysis involved 185 patients with CSVD, comprising 87 cases with MCI and 98 cases without MCI (NMCI). Analyses of demographic and clinical characteristics were conducted. DTI-measured fractional anisotropy (FA) and mean diffusivity (MD) in the hippocampus and entorhinal cortex regions were examined. The diagnostic values were determined using receiver-operative-curve (ROC) analysis, with the Youden index identifying optimum sensitivity and specificity. Correlations between Montreal cognitive assessment (MoCA) scores and FA or MD in patients with MCI were further assessed. No significant differences were observed in demographic and clinical characteristics between MCI and NMCI groups (all > 0.05), except for diabetes prevalence ( = 0.011). Notably, the ROC analysis highlighted the diagnostic potential of FA, showing the maximum area under the curve values (hippocampus-left: 0.76; hippocampus-right: 0.66; entorhinal cortex-left: 0.62; entorhinal cortex-right: 0.64). MD exhibited a significant negative correlation with MoCA scores (hippocampus-left: = -0.58, < 0.001; hippocampus-right: = -0.41, < 0.001; entorhinal cortex-Lleft: = -0.49, < 0.001; entorhinal cortex-right: = -0.27, < 0.001), whereas FA showed a significant positive correlation (hippocampus-left: = 0.51, < 0.001; hippocampus-right: = 0.31, = 0.004; entorhinal cortex-left: = 0.35, < 0.001; entorhinal cortex-right: = 0.38, < 0.001). The study demonstrates the diagnostic value of DTI parameters in CSVD patients with MCI, emphasizing the associations between microstructural brain changes and cognitive function. Diffusion tensor imaging (DTI)-measured fractional anisotropy and mean diffusivity demonstrate significant correlation with cognitive function, highlighting the diagnostic potential of DTI parameters in cerebral small vessel disease patients with mild cognitive impairment. Current findings emphasize the associations between microstructural brain changes and cognitive function.

摘要

脑小血管病(CSVD)所致轻度认知障碍(MCI)与认知功能下降有关。脑萎缩被认为是MCI患者最常见的变化,可通过扩散张量成像(DTI)进行测量。本研究旨在探讨DTI参数与CSVD合并MCI患者认知功能之间的关系。这项回顾性分析纳入了185例CSVD患者,其中87例为MCI患者,98例为非MCI(NMCI)患者。对人口统计学和临床特征进行了分析。检测了海马体和内嗅皮质区域DTI测量的分数各向异性(FA)和平均扩散率(MD)。使用受试者工作特征曲线(ROC)分析确定诊断价值,约登指数确定最佳敏感性和特异性。进一步评估了MCI患者蒙特利尔认知评估(MoCA)评分与FA或MD之间的相关性。MCI组和NMCI组在人口统计学和临床特征方面未观察到显著差异(均>0.05),除了糖尿病患病率(=0.011)。值得注意的是,ROC分析突出了FA的诊断潜力,显示曲线下面积最大值(左侧海马体:0.76;右侧海马体:0.66;左侧内嗅皮质:0.62;右侧内嗅皮质:0.64)。MD与MoCA评分呈显著负相关(左侧海马体:=-0.58,<0.001;右侧海马体:=-0.41,<0.001;左侧内嗅皮质:=-0.49,<0.001;右侧内嗅皮质:=-0.27,<0.001),而FA呈显著正相关(左侧海马体:=0.51,<0.001;右侧海马体:=0.31,=0.004;左侧内嗅皮质:=0.35,<0.001;右侧内嗅皮质:=0.38,<0.001)。该研究证明了DTI参数在CSVD合并MCI患者中的诊断价值,强调了脑微观结构变化与认知功能之间的关联。扩散张量成像(DTI)测量的分数各向异性和平均扩散率与认知功能显著相关,突出了DTI参数在脑小血管病合并轻度认知障碍患者中的诊断潜力。当前研究结果强调了脑微观结构变化与认知功能之间的关联。

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