轻度认知障碍中小血管疾病进展与纵向认知衰退的关联
Association of small vessel disease progression with longitudinal cognitive decline across mild cognitive impairment.
作者信息
Wang Jingru, Debora Asta, Chen Lixuan, Chen Haisong, Zhao Xuemiao, Yu Mengying, Yang Yunjun
机构信息
Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.
出版信息
J Alzheimers Dis. 2025 Feb;103(3):714-723. doi: 10.1177/13872877241305800. Epub 2025 Jan 10.
BACKGROUND
Cerebral small vessel disease (SVD) is the leading cause of vascular dementia. However, it is unclear whether the individual SVD or global SVD progression correlates with cognitive decline across mild cognitive impairment (MCI) subjects.
OBJECTIVE
To investigate the association of small vessel disease progression with longitudinal cognitive decline across MCI.
METHODS
We included 432 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, with 151 participants in the cognitively normal (CN) group and 281 participants in the MCI group. We evaluated magnetic resonance imaging-based SVD markers in both CN and MCI groups and explored their associations with 12-and 24-month cognitive decline using linear mixing effect (LME) models.
RESULTS
In the CN group, cerebral microbleed (CMB) progression was associated with the decline in language function (p < 0.05), and deep white matter hyperintensity (WMH) progression was associated with a decline in memory function (p < 0.05). In the MCI group, CMB progression was associated with a decline in memory function (p < 0.05) and lacunes progression was associated with executive function (p < 0.05), whereas the progression of global SVD score was not related to longitudinal cognitive function.
CONCLUSIONS
The progression of CMB and WMH had an impact on cognitive decline in both CN and MCI groups, and lacunes progression only had an association with cognitive decline in the MCI group. Our study suggested that individual SVD markers may have a higher predictive value in longitudinal cognition compared with global SVD burden.
背景
脑小血管病（SVD）是血管性痴呆的主要病因。然而，尚不清楚个体SVD或整体SVD进展是否与轻度认知障碍（MCI）受试者的认知衰退相关。
目的
研究MCI患者中小血管病进展与纵向认知衰退之间的关联。
方法
我们纳入了来自阿尔茨海默病神经影像学倡议（ADNI）数据库的432名参与者，其中认知正常（CN）组有151名参与者，MCI组有281名参与者。我们评估了CN组和MCI组基于磁共振成像的SVD标志物，并使用线性混合效应（LME）模型探讨它们与12个月和24个月认知衰退的关联。
结果
在CN组中，脑微出血（CMB）进展与语言功能衰退相关（p<0.05），深部白质高信号（WMH）进展与记忆功能衰退相关（p<0.05）。在MCI组中，CMB进展与记忆功能衰退相关（p<0.05），腔隙进展与执行功能相关（p<0.05），而整体SVD评分的进展与纵向认知功能无关。
结论
CMB和WMH的进展对CN组和MCI组的认知衰退均有影响，腔隙进展仅与MCI组的认知衰退相关。我们的研究表明，与整体SVD负担相比，个体SVD标志物在纵向认知方面可能具有更高的预测价值。
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