健康老年人脑白质病变体积与认知障碍的关系

The relationships between white matter leisons on cognition in the healthy elderly

目的通过利用半自动化分析软件对脑白质病变患者不同区域白质损伤(f MRI序列上的高信号)进行定量,并对其与认知功能评分进行分析,探讨脑白质病变体积与认知障碍的关系。方法选取承德市中心医院门诊"健康"人群75例。采用简易智能状态检查量表(MMSE)及蒙特利尔认知评价量表(MoCA)对其进行认知功能评价。基于FLAIR定量计算全脑、侧脑室旁及深部皮质下脑白质受损体积,将认知功能评分与以上白质受损体积进行偏相关分析。将脑白质病变患者分为轻度认知障碍组和对照组,比较两组认知障碍特点。结果控制年龄、性别、文化程度后,全脑白质体积与认知功能评分MoCA有偏相关性(r=-0. 541,P=0. 001),尤其是侧脑室旁白质体积(r=-0. 518,P=0. 000),与深部白质也存在偏相关性(r=-0. 312,P=0. 025);全脑白质体积与认知功能评分MMSE(r=-0. 303,P=0. 033),侧脑室旁体积与认知功能评分MMSE (r=-0. 330,P=0. 019)及深部白质损伤体积(r=-0. 257,P=0. 039)。脑白质病变体积认知障碍组与对照组在执行功能及视空间(P=0. 003)、注意力(P=0. 041)、语言(P=0. 040)及记忆力(P=0. 000)方面评分差异具有明显统计学意义(P <0. 05)。结论全脑、侧脑室旁、皮质下脑白质损伤体积增大,认知功能评分随之下降;全脑白质体积与MoCA的相关性比与MMSE相关性大;而且,侧脑室旁体积与深部白质损伤体积相比,与认知功能的相关性更大。脑白质病变体积引起轻度认知障碍主要表现在执行功能、注意力、视空间及记忆力方面。

Objective Explore the characteristics of cognitive impairment caused by white matter leisons(high signal on FLAIR sequence),especially the volume and location,which be analyzed using a quantitatively semiautomated software.Methods We used two scales including MMSE and MoCA to assess the cognitive function of 63‘healthy’subjects who come to Chengde Central Hospital,and then all subjects’brain MRI images were conducted by a 3T(Trio Tim,superconducting MRI system,Siemens)in the Department of Radiology,Chengde Central Hospital,including T 1-weighted 3D structural,T 2-weighted and FLAIR sequence MRI,and then volume and locations(whole brain,periventricular and subcortical deep brain white matter)of WMH on FLAIR sequence which representing the damage of white matter were quantitative detected.At last,a partial correlation analysis between white matter damage and cognitive function score were done.Patients with white matter lesions were divided into mild cognitive impairment group and control group,compared the two groups of cognitive impairment.Results Controlling the age,gender and education level,there is a partial correlation between the volume of whole brain white matter and MoCA score(r=-0.541,P=0.001),especially the volume of periventricular white matter(r=-0.518,P=0.000),while deep white matter is(r=-0.312,P=0.025).There is a partial correlation between the volume of whole brain white matter and MMSE score(r=-0.303,P=0.033),especially the volume of periventricular white matter(r=-0.330,P=0.019),and deep white matter is(r=-0.257,P=0.039).WMLV-MCI group compared with WMLV-NC group.PWMLV group in the implementation of functional and visual space(P=0.003),attention(P=0.041)and memory(P=0.000)score difference was statistically significant(P<0.05).Conclusion There is a correlation between the decreased cognitive function score and white matter damage volume.The correlation between whole white matter volume and MoCA was greater than that of MMSE.Moreover,the volume of the lateral ventricle is associated with greater cognitive function than the volume of deep white matter lesions.The volume of white matter lesions caused by mild cognitive impairment mainly in the executive function,attention,visual space and memory.