Ito Takahiro, Fujiyoshi Akira, Ohkubo Takayoshi, Shiino Akihiko, Shitara Satoshi, Miyagawa Naoko, Torii Sayuki, Hisamatsu Takashi, Segawa Hiroyoshi, Kondo Keiko, Kadota Aya, Tooyama Ikuo, Watanabe Yoshiyuki, Yoshida Kazumichi, Nozaki Kazuhiko, Miura Katsuyuki
Department of Radiology, Shiga University of Medical Science, Otsu, Japan.
Department of Hygiene, School of Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Cerebrovasc Dis. 2025 Jun 12:1-11. doi: 10.1159/000546882.
Intracranial subclinical vessel diseases are considered important indicators of cognitive impairment. However, a comprehensive assessment of various types of vessel disease, particularly in Asian populations, is lacking. We aimed to compare multiple types of intracranial vessel disease in association with cognitive function among a community-based Japanese male population.
The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) randomly recruited and examined a community-based cohort of Japanese men from Shiga, Japan. We analyzed those who underwent the Cognitive Abilities Screening Instrument (CASI) assessment and cranial magnetic resonance imaging/angiogram (MRI/MRA) in 2010-2015. Using MRI/MRA, we assessed lacunar infarction, microbleeds, periventricular hyperintensity (PVH), deep subcortical white matter hyperintensity (DSWMH), and intracranial artery stenosis (ICAS). We divided these subclinical cerebrovascular diseases (SCDs) into three categories according to severity. Using linear regression, we calculated the CASI score according to the grade of each vessel disease, adjusted for age and years of education.
In the adjusted models, CASI scores were significantly associated with both PVH and DSWMH. Specifically, multivariable-adjusted CASI scores declined across increasing severity categories of DSWMH (91.7, 91.2, and 90.4; p for trend = 0.011) and PVH (91.5, 90.4, and 89.7; p for trend = 0.006). Other SCDs did not show significant associations. In stratified analyses based on the presence or absence of each SCD, both DSWMH and PVH demonstrated significant inverse trends with CASI scores in the absence of lacunar infarcts and microbleeds and in the presence of ICAS. Additionally, among participants with PVH (+), ≥moderate ICAS was significantly associated with lower CASI scores.
PVH and DSWMH showed significant dose-response relationships with cognitive function among community-based Japanese men. These findings suggest that white matter lesions may be an important indicator of early cognitive impairment, and severe ICAS may also play a role in those with PVH.
颅内亚临床血管疾病被认为是认知障碍的重要指标。然而，目前缺乏对各类血管疾病的全面评估，尤其是在亚洲人群中。我们旨在比较日本社区男性人群中多种类型的颅内血管疾病与认知功能之间的关系。
滋贺亚临床动脉粥样硬化流行病学研究（SESSA）随机招募并检查了来自日本滋贺的社区队列日本男性。我们分析了那些在2010 - 2015年接受认知能力筛查工具（CASI）评估和头颅磁共振成像/血管造影（MRI/MRA）的患者。通过MRI/MRA，我们评估了腔隙性梗死、微出血、脑室周围白质高信号（PVH）、深部皮质下白质高信号（DSWMH）和颅内动脉狭窄（ICAS）。我们根据严重程度将这些亚临床脑血管疾病（SCDs）分为三类。使用线性回归，我们根据每种血管疾病的分级计算CASI评分，并对年龄和受教育年限进行了调整。
在调整模型中，CASI评分与PVH和DSWMH均显著相关。具体而言，多变量调整后的CASI评分随着DSWMH严重程度类别增加而下降（91.7、91.2和90.4；趋势p值 = 0.011）以及PVH（91.5、90.4和89.7；趋势p值 = 0.006）。其他SCDs未显示出显著相关性。在基于每种SCD存在与否的分层分析中，在无腔隙性梗死和微出血且存在ICAS的情况下，DSWMH和PVH均与CASI评分呈现显著的负相关趋势。此外，在PVH（+）的参与者中，≥中度ICAS与较低的CASI评分显著相关。
在日本社区男性中，PVH和DSWMH与认知功能呈现显著的剂量反应关系。这些发现表明，白质病变可能是早期认知障碍的重要指标，并且严重的ICAS在患有PVH的人群中也可能起作用。
