Breteler M M, van Amerongen N M, van Swieten J C, Claus J J, Grobbee D E, van Gijn J, Hofman A, van Harskamp F
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Stroke. 1994 Jun;25(6):1109-15. doi: 10.1161/01.str.25.6.1109.
Ventricular enlargement and white matter lesions are frequent findings on cerebral magnetic resonance imaging scans of elderly subjects. In demented subjects they seem related to the severity of the dementia, but in nondemented subjects their clinical significance is less clear. We investigated the relation of size of the lateral ventricles and white matter lesions with cognitive function in a population-based random sample of nondemented elderly persons.
The study population consisted of 90 subjects, aged 65 to 84 years, who were randomly selected from the cohort of the Rotterdam Study, and who were not demented. The presence of white matter lesions and the ventricle-to-brain ratio were assessed on magnetic resonance scans. Participants were tested with a neuropsychological battery that covered a broad range of cognitive functions.
Ventricular enlargement and white matter lesions were both and independently associated with poorer performance on all tests. After adjustment for age and sex, ventricular enlargement was significantly associated with worse scores on tests assessing global cognitive function (Mini-Mental State Examination, P = .02; Groninger Intelligence Test, P = .01), memory (Word List Learning delayed recall, P = .03), and executive control functions (Stroop part II, P = .02; Trial Making Test B, P < .01); for white matter lesions the differences were significant for tests measuring executive control functions and mental speed (Trail Making Test A and B, P = .01 and P < .01, respectively; verbal fluency, P = .01), and memory (Word List Learning delayed recall, P = .04).
This study suggests that white matter lesions are primarily related to impairment of subcorticofrontal functions, whereas enlargement of the lateral ventricles is associated with disturbances of cortical functions as well.
脑室扩大和白质病变是老年受试者脑磁共振成像扫描中常见的表现。在痴呆患者中，它们似乎与痴呆的严重程度相关，但在非痴呆患者中，其临床意义尚不清楚。我们在一个基于人群的非痴呆老年人随机样本中，研究了侧脑室大小和白质病变与认知功能的关系。
研究人群包括90名年龄在65至84岁之间的受试者，他们是从鹿特丹研究队列中随机选取的，且未患痴呆。通过磁共振扫描评估白质病变的存在情况以及脑室与脑的比例。参与者接受了一套涵盖广泛认知功能的神经心理测试。
脑室扩大和白质病变均与所有测试中的较差表现独立相关。在调整年龄和性别后，脑室扩大与评估整体认知功能（简易精神状态检查表，P = 0.02；格罗宁根智力测试，P = 0.01）、记忆（单词表学习延迟回忆，P = 0.03）和执行控制功能（斯特鲁普测试第二部分，P = 0.02；连线测验B，P < 0.01）的测试得分较差显著相关；对于白质病变，在测量执行控制功能和心理速度（连线测验A和B，分别为P = 0.01和P < 0.01；语言流畅性，P = 0.01）以及记忆（单词表学习延迟回忆，P = 0.04）的测试中差异显著。
本研究表明，白质病变主要与皮质下前额叶功能受损有关，而侧脑室扩大也与皮质功能障碍有关。
