脑小血管病伴认知功能障碍患者脑白质改变的研究进展

Research advance in changes of brain white matter in cerebral small vessel disease with cognitive impairment

随着我国人口老龄化程度的逐渐加深,脑小血管病正日益成为威胁人类健康的常见病、多发病,是导致认知功能下降的常见原因。脑白质改变特别是脑白质高信号是脑小血管病最为常见和典型的影像学标志物。近年来的多项研究发现脑白质高信号与认知功能的下降相关。这些研究主要聚焦于白质高信号与认知功能脆弱的关系、白质高信号的大小、部位及动态演变与脑小血管病伴认知障碍的相关性。功能磁共振影像研究提示脑小血管病伴认知障碍患者脑白质改变与结构网络连接存在异常。结构网络因其具有较好的稳定性,可用于定量分析。扩散张量成像及多维参数的结构网络定量测量研究发现,白质高信号区存在结构网络完整性破坏、网络连接效率下降、连接中断的改变。大数据及人工智能研究能对脑小血管病伴认知障碍患者白质高信号及结构网络异常做出及早预测。这些研究为脑小血管病伴认知障碍患者早期白质异常微小改变提供了可靠的依据。本文就近几年脑小血管病伴认知障碍患者磁共振白质高信号与脑结构网络的研究进展进行综述,目的是提高对其早诊断,进而促进其早期预防和治疗。

With the progress of population aging,cerebral small vessel disease is increasingly becoming a common and frequent disease threatening human health,which is a common reason leaing to cognitive function decline.The changes of white matter,especially white matter hyperintensities,are the most common and typical imaging marker of small cerebral vascular disease.In recent years,a number of studies has found that white matter hyperintensities are associated with cognitive decline.These studies mainly focused on the relationship between white matter hyperintensities and cognitive frailty,and the correlation between the size,location and dynamic evolution of white matter hyperintensities and cognitive impairment of small cerebral vascular disease.Functional magnetic resonance imaging studies also revealed that patients with cognitive impairment of cerebral small vessel disease had abnormal white matter changes and structural network connectivity.Structural network can be used for quantitative analysis because of its good stability.Diffusion tensor imaging and quantitative measurement of multi-dimensional structural network were used qualitatively.It was found that the structural network integrity was damaged,the network connection efficiency was reduced,and the connection was interrupted within the white matter hyperintensity.Big data and artificial intelligence research can make early prediction of white matter hyperintensity and structural networks in patients with cerebral small vessel disease with cognitive impairment.These studies provide a reliable basis for the discovery of abnormal microstructure and network changes in the early stage of white matter hyperintensities in cerebral small vessel disease with cognitive impairment.The paper reviews the research progress of white matter hyperintensity and brain structural network in patients with cognitive impairment of cerebral small vessel disease in recent years,and in order to improve the early diagnosis of the disease and promote the early prevention and treatment.