缺血性脑白质疏松患者基于体素的脑结构特征研究

Voxel-based Morphometric Study of Brain Structure in Patients of Leukoaraiosis

目的:用基于体素的形态学分析(VBM)方法,探讨缺血性脑白质疏松(LA)患者大脑灰质体积是否存在异常及其分布特征。方法:LA认知功能障碍患者34例和年龄、性别、受教育程度相匹配的正常老年人23名(对照组)纳入研究。所有被试均进行了认知功能测查和3.0T磁共振影像检查,根据认知量表评分结果将LA组分为LA轻度认知功能障碍(LA-MCI)组和LA血管性痴呆(LA-VD)组。采用VBM对所有被试大脑灰质密度和灰质体积进行基于体素检测和比较,分析LA认知功能障碍患者大脑灰质密度减少区域、分布特征及其临床意义。结果:与对照组相比,LA-VD组左前额叶及黑索回大脑灰质密度减低(P<0.05);LA-MCI组右中央前后回及左顶上回、左尾状核区灰质密度减低(P<0.05);与LA-MCI组比较,LA-MCI组左额中回和右额中回灰质密度减低(P<0.05)。LA认知功能障碍患者执行功能分数与左额中叶灰质体积显著相关(P<0.05)。结论:LA患者存在广泛的大脑灰质萎缩,执行功能下降与其密切相关。

Objective： To explore the abnormalities in structure and distribution of gray matter （GM） in leukoar- aiosis （LA） patients by voxel-based morphometric （VBM）. Methods： This study involved 34 LA patients with cognitive impairment and 23 normal individuals （control group）; subjects were matched for age, sex, and educa- tion level. All participants underwent neurocognitive tests and 3.0T magnetic resonance imaging （MRI）. Based on cognitive scale ratings, the LA group was further divided into mild cognitive impairment （LA-MCI） and vas- cular dementia （LA-VaD） groups. VBM was employed to assess characteristics of GM density and volume in all participants, and location and distribution of reduced GM density in LA patients were analyzed for clinical signif- icance. Results： Compared with the control group, the LA-VaD group showed decreased GM density of the left prefrontal cortex and Heschl＇s gyms （P〈0.05）; the LA-MCI group displayed decreased GM density of the right frontal cortex, left parietal gyms, and left caudate nucleus （P〈0.05）; compared with the control group, the LA-MCI group showed decreased GM density in the left middle frontal gyrus and right middle frontal gyms （P〈 0.05）. Executive function scores of LA patients with cognitive impairment were significantly correlated with left middle frontal lobe GM volume （P〈0.05）. Conclusion： There are broad areas of gray matter loss in LA patients. Decline of executive function is significantly correlated with loss of gray matter.