阿尔茨海默病中脑白质疏松症的神经心理学、精神病学及脑灌注相关性
Neuropsychological, psychiatric, and cerebral perfusion correlates of leukoaraiosis in Alzheimer's disease.
作者信息
Starkstein S E, Sabe L, Vázquez S, Di Lorenzo G, Martínez A, Petracca G, Tesón A, Chemerinski E, Leiguarda R
机构信息
Department of Behavioral Neurology, Raúl Carrea Institute of Neurological Research, Buenos Aires, Argentina.
出版信息
J Neurol Neurosurg Psychiatry. 1997 Jul;63(1):66-73. doi: 10.1136/jnnp.63.1.66.
OBJECTIVE
To examine neurological, neuropsychological, psychiatric, and cerebral perfusion correlates of leukoaraiosis in Alzheimer's disease.
METHODS
A consecutive series of patients with probable Alzheimer's disease was assessed with a comprehensive neuropsychological battery, a structured psychiatric evaluation, the unified Parkinson's disease rating scale, MRI, and single photon emission computed tomography with technetium 99m hexamethylpropyleneamine oxime (HMPAO) and regional cerebral perfusion measurements.
RESULTS
Patients with Alzheimer's disease and leukoaraiosis were significantly more apathetic and had significantly more extrapyramidal signs than patients with Alzheimer's disease without leukoaraiosis. Patients with Alzheimer's disease with leukoaraiosis also had significantly lower bilateral perfusion in the basal ganglia, thalamus, and frontal lobes than patients with Alzheimer's disease without leukoaraiosis. On the other hand, there were no significant differences between groups in age, duration of illness, depression scores, severity of delusions, or deficits on specific neuropsychological tasks.
CONCLUSIONS
Leukoaraiosis in Alzheimer's disease may produce significant basal ganglia, and thalamic and frontal lobe dysfunction, which may be associated with more severe apathy and extrapyramidal signs.
目的
研究阿尔茨海默病中脑白质疏松症的神经学、神经心理学、精神病学及脑灌注相关性。
方法
对一系列连续的可能患有阿尔茨海默病的患者进行全面的神经心理测试、结构化精神评估、统一帕金森病评定量表评估、MRI检查以及使用锝99m六甲基丙烯胺肟（HMPAO）进行单光子发射计算机断层扫描和区域脑灌注测量。
结果
与无脑白质疏松症的阿尔茨海默病患者相比，患有脑白质疏松症的阿尔茨海默病患者明显更冷漠，锥体外系症状也明显更多。患有脑白质疏松症的阿尔茨海默病患者双侧基底节、丘脑和额叶的灌注也明显低于无脑白质疏松症的阿尔茨海默病患者。另一方面，两组在年龄、病程、抑郁评分、妄想严重程度或特定神经心理任务的缺陷方面没有显著差异。
结论
阿尔茨海默病中的脑白质疏松症可能导致基底节、丘脑和额叶功能显著异常，这可能与更严重的冷漠和锥体外系症状有关。
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