运动认知风险综合征的研究进展

Research progress of motor cognitive risk syndrome

运动认知风险综合征(Motor Cognitive Risk Syndrome,MCR)以在非痴呆老年人群中同时存在步态缓慢和主观认知功能下降为特点,是一种痴呆症的前期症状,发展成阿尔茨海默病(Alzheimer's Disease,AD)和血管性痴呆(Vascular Dementia,VaD)的风险增加。与单独的步态缓慢或主观记忆减退相比,MCR患者发展成为痴呆的风险更高。MCR的致残特征包括传入感觉和传出运动反应的异常,以及视觉、前庭和本体感觉在中枢整合的破坏。MCR的病理基础与额叶腔隙灶、脑白质疏松、运动前区和前额叶皮层萎缩、胆碱能功能异常、炎症反应和遗传因素有关。本综述的目的是深入阐述MCR这一痴呆临床前阶段的危险因素,步态异常表现和认知之间的重要联系,以及其在预测痴呆风险中的作用。

Motor cognitive risk syndrome(MCR)is characterized by slow gait and decreased subjective cognitive function in non dementia elderly people.It is an early symptom of dementia.The risk of developing Alzheimer's disease(AD)and vascular dementia(VaD)increases.Patients with MCR have a higher risk of developing dementia than those with slow gait or impaired subjective memory alone.The disabling characteristics of MCR comprise altered afferent sensory and efferent motor responses,together with disrupted visual,vestibular,and proprioceptive components.The pathological basis of MCR relates to frontal lacunar infarcts,white matter hyperintensity(WMH),gray matter atrophy in the pre-motor and pre-frontal cortex,abnormal cholinergic functioning,inflammatory responses,and genetic factors.The purpose of this review is to further understand the risk factors of MCR in the preclinical stage of dementia,the important relationship between gait abnormalities and cognition,and its role in predicting the risk of dementia.