皮层下缺血性脑血管病白质纤维束与认知功能的关系

Relationships of white matter fiber bundles and cognitive function in subcortical ischemic vascular disease

目的观察皮层下缺血性血管病(SIVD)白质纤维束与认知功能的关系。方法纳入32例SIVD认知功能障碍者(SIVD-CI组)、35例SIVD认知功能正常者(SIVD-NC组)和36名非SIVD者(对照组),比较3组间整体及每2组间认知功能及纤维束弥散张量成像(DTI)各向异性分数(FA)的差异,观察纤维束FA与认知功能的关系。结果3组神经心理学量表5个认知域评分差异均有统计学意义(P均<0.01)。除双侧小脑下脚及左侧小脑上脚外,3组纤维束FA差异均有统计学意义(P均<0.05);除双侧扣带回外,SIVD-CI组与对照组纤维束FA差异均有统计学意义(P均<0.05);除右侧小脑上脚及左侧钩束外,SIVD-NC组与对照组纤维束FA差异均有统计学意义(P均<0.05)。SIVD-CI组双侧内囊豆状核后部、左侧丘脑后辐射、右侧前辐射及双侧扣带回纤维束FA均低于SIVD-NC组(P均<0.05)。SIVD-CI组左侧丘脑后辐射纤维束FA与注意力(r=0.42,P=0.02)、记忆力(r=0.41,P=0.03)、执行力(r=0.39,P=0.04)及语言能力(r=0.43,P=0.02)呈正相关;SIVD-NC组右侧扣带回纤维束FA与记忆力(r=0.39,P=0.03)及语言能力(r=0.37,P=0.04)呈正相关。结论SIVD-CI患者左侧丘脑后辐射纤维束FA与注意力、记忆力、执行力及语言能力呈正相关,SIVD-NC患者右侧扣带回纤维束FA与记忆力及语言能力呈正相关。

Objective To observe the relationship between white matter fiber bundles and cognitive function in subcortical ischemic vascular disease(SIVD).Methods Thirty-two SIVD patients with cognitive impairment(SIVD-CI group),35 SIVD patients with normal cognition(SIVD-NC group)and 36 patients without SIVD(control group)were enrolled.The cognitive function and diffusion tensor imaging(DTI)fractional anisotropy(FA)of fiber bundle were compared among 3 groups and between each 2 groups.The relationships between fiber bundle FA and cognitive function were observed.Results There were significant differences of five cognitive domains scores of neuropsychological scale among 3 groups(all P<0.01).Except bilateral inferior cerebellar peduncle and left superior cerebellar peduncle,there were significant differences of fiber bundle FA among 3 groups(all P<0.05).Except bilateral cingulate gyrus,there were significant differences of fiber bundle FA between SIVD-CI group and control group(all P<0.05),and except for right superior cerebellar peduncle and left uncinate tract,there were significant differences of fiber bundle FA between SIVD-NC group and control group(all P<0.05).The fiber bundle FA of posterior part of bilateral internal lenticular nucleus,posterior radiation of left thalamus,anterior radiation of right side and bilateral cingulate tracts in SIVD-CI group were lower than those in SIVD-NC group(all P<0.05).In SIVD-CI group,FA of posterior radiation of left thalamic fiber bundle was positively correlated with attention(r=0.42,P=0.02),memory(r=0.41,P=0.03),executive ability(r=0.39,P=0.04)and language ability(r=0.43,P=0.02).In SIVD-NC group,FA of right cingulate fiber bundle was positively correlated with memory(r=0.39,P=0.03)and language ability(r=0.37,P=0.04).Conclusion FA of posterior radiation of left thalamic fiber bundle was positively correlated with attention,memory,executive ability and language ability in SIVD-CI patients,while FA of right cingulate fiber bundle was positively correlated with memory and language ability in SIVD-NC patients.