Background: The Geriatric Depression Scale (GDS) is widely used to assess depressive symptoms in clinical and research settings. This study utilized a 4 factor solution for the 30-item GDS to explore differences in th...Background: The Geriatric Depression Scale (GDS) is widely used to assess depressive symptoms in clinical and research settings. This study utilized a 4 factor solution for the 30-item GDS to explore differences in the presentation of depressive symptoms in various types of cognitive impairment. Method: Retrospective chart review was conducted on 254 consecutive cases of community dwelling elderly newly diagnosed with mild Alzheimer’s Dementia (AD) n = 122, mild Vascular Dementia (VaD) n = 71 or Amnestic Mild Cognitive Impairment (aMCI) n = 32 and Non-Amnestic MCI (nMCI) n = 29. Results: Analysis revealed no significant differences (p 05). No statistically significant differences were found between VaD and nMCI or between the MCI groups. Conclusions: Support is provided for the use of GDS subscales in a wide range of cognitively impaired elderly. This study suggests in mild dementia the number and type of depressive symptoms vary significantly between AD and VaD. There are indications that aMCI patients are similar in their symptom endorsement to AD and nMCI are similar to VaD which is consistent with some of the notions regarding likely trajectories of the respective MCI groups.展开更多
Vascular mild cognitive impairment(VaMCI)represents the early stage of symptoms of vascular cognitive impairment(VCI).There are many intervention factors in this period.If the active treatment can delay the further de...Vascular mild cognitive impairment(VaMCI)represents the early stage of symptoms of vascular cognitive impairment(VCI).There are many intervention factors in this period.If the active treatment can delay the further development of the disease and even reduce the risk of transforming into vascular dementia(VaD).As a widely used imaging method,multi-mode magnetic resonance imaging can evaluate the brain structure and function of patients with VaMCI noninvasively and explore the relationship between brain structure,function and cognitive function change.It is beneficial to provide an idea for early diagnosis of VaMCI and to further understand the neuropathologic mechanism of its occurrence,which has broad application prospects.In this paper,the research status and new methods of VaMCI are reviewed by using multi-mode magnetic resonance imaging in recent years.展开更多
OBJECTIVE： To treat patients with vascular mild cognitive impairment （VMCI） using traditional Chinese medicine （TCM）, it is necessary to classify the patients into TCM syndrome types and to apply different treatm...OBJECTIVE： To treat patients with vascular mild cognitive impairment （VMCI） using traditional Chinese medicine （TCM）, it is necessary to classify the patients into TCM syndrome types and to apply different treatments to different types. In this paper, we investigate how to properly carry out the classification for patients with VMCI aged 50 or above using a novel data-driven method known as latent tree analysis （LTA）. METHOD： A cross-sectional survey on VMCI was carried out in several regions in Northern China between February 2008 and February 2012 which resulted in a data set that involves 803 patients and 93 symptoms. LTA was performed on the data to reveal symptom co-occurrence patterns, and the patients were partitioned into clusters in multiple ways based on the patterns. The patient clusters were matched up with syndrome types, and population statistics of the clusters are used to quantify the syndrome types and to establish classification rules. RESULTS： Eight syndrome types are identified： Qi deficiency, Qi stagnation, Blood deficiency, Blood stasis, Phlegm-dampness, Fire-heat, Yang deficiency, and Yin deficiency. The prevalence and symptom occurrence characteristics of each syndrome type are determined. Quantitative classification rules are established for determining whether a patient belongs to each of the syndrome types. CONCLUSION： A solution for the TCM syndrome classification problem for patients with VMCI and aged 50 or above is established based on the LTA of unlabeled symptom survey data. The results can be used as a reference in clinic practice to improve the quality of syndrome differentiation and to reduce diagnosis variances across physicians. They can also be used for patient selection in research projects aimed at finding biomarkers for the syndrome types and in randomized control trials aimed at determining the efficacy of TCM treatments of VMCI.展开更多
Subcortical vascular mild cognitive impairment(svMCI)is a common prodromal stage of vascular dementia.Although mounting evidence has suggested abnormalities in several single brain network metrics,few studies have exp...Subcortical vascular mild cognitive impairment(svMCI)is a common prodromal stage of vascular dementia.Although mounting evidence has suggested abnormalities in several single brain network metrics,few studies have explored the consistency between functional and structural connectivity networks in svMCI.Here,we constructed such networks using resting-state f MRI for functional connectivity and diffusion tensor imaging for structural connectivity in 30 patients with svMCI and 30 normal controls.The functional networks were then parcellated into topological modules,corresponding to several well-defined functional domains.The coupling between the functional and structural networks was finally estimated and compared at the multiscale network level(whole brain and modular level).We found no significant intergroup differences in the functional–structural coupling within the whole brain;however,there was significantly increased functional–structural coupling within the dorsal attention module and decreased functional–structural coupling within the ventral attention module in the svMCI group.In addition,the svMCI patients demonstrated decreased intramodular connectivity strength in the visual,somatomotor,and dorsal attention modules as well as decreased intermodular connectivity strength between several modules in the functional network,mainly linking the visual,somatomotor,dorsal attention,ventral attention,and frontoparietal control modules.There was no significant correlation between the altered module-level functional–structural coupling and cognitive performance in patients with svMCI.These findings demonstrate for the first time that svMCI is reflected in a selective aberrant topological organization in multiscale brain networks and may improve our understanding of the pathophysiological mechanisms underlying svMCI.展开更多
目的:探讨不同部位脑白质高信号及脑小血管病负荷积分与血管性轻度认知障碍的相关性。方法:选取2020年8月—12月中关村医院门诊及康复病房收治的血管性轻度认知障碍患者14例,设为VaMCI组;正常组12例。采用MRI扫描技术,利用脑医生平台统...目的:探讨不同部位脑白质高信号及脑小血管病负荷积分与血管性轻度认知障碍的相关性。方法:选取2020年8月—12月中关村医院门诊及康复病房收治的血管性轻度认知障碍患者14例,设为VaMCI组;正常组12例。采用MRI扫描技术,利用脑医生平台统计患者不同部位脑白质高信号数目,采用简易精神状态检查(Mini-Mental State Examination,MMSE)和蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评定受试者认知功能,并对所有患者的MRI图像进行脑小血管病负荷评分。结果:VaMCI组白质高信号总数目、皮层下白质高信号数目及CSVD负荷积分与正常组差异有统计学意义(P<0.05)。VaMCI组脑室周白质高信号数目与正常组差异无统计学意义(P>0.05)。MMSE、MoCA评分与白质高信号总数目、皮层下白质高信号数目及CSVD负荷积分存在负相关性。年龄与白质高信号总数目、皮层下白质高信号数目及CSVD负荷积分存在正相关性。结论:血管性轻度认知障碍患者脑白质高信号部位以皮层下为主,结合脑小血管病负荷积分可预测认知功能下降。展开更多
文摘Background: The Geriatric Depression Scale (GDS) is widely used to assess depressive symptoms in clinical and research settings. This study utilized a 4 factor solution for the 30-item GDS to explore differences in the presentation of depressive symptoms in various types of cognitive impairment. Method: Retrospective chart review was conducted on 254 consecutive cases of community dwelling elderly newly diagnosed with mild Alzheimer’s Dementia (AD) n = 122, mild Vascular Dementia (VaD) n = 71 or Amnestic Mild Cognitive Impairment (aMCI) n = 32 and Non-Amnestic MCI (nMCI) n = 29. Results: Analysis revealed no significant differences (p 05). No statistically significant differences were found between VaD and nMCI or between the MCI groups. Conclusions: Support is provided for the use of GDS subscales in a wide range of cognitively impaired elderly. This study suggests in mild dementia the number and type of depressive symptoms vary significantly between AD and VaD. There are indications that aMCI patients are similar in their symptom endorsement to AD and nMCI are similar to VaD which is consistent with some of the notions regarding likely trajectories of the respective MCI groups.
基金Projects Funded by Scientific and Technological Activities of Overseas Students in Shanxi Province in 2018,Project No:Jincaishe[2018]No.123Shanxi Province's Key Research and Development Projects in Social Development.Project No:201803D31129.
文摘Vascular mild cognitive impairment(VaMCI)represents the early stage of symptoms of vascular cognitive impairment(VCI).There are many intervention factors in this period.If the active treatment can delay the further development of the disease and even reduce the risk of transforming into vascular dementia(VaD).As a widely used imaging method,multi-mode magnetic resonance imaging can evaluate the brain structure and function of patients with VaMCI noninvasively and explore the relationship between brain structure,function and cognitive function change.It is beneficial to provide an idea for early diagnosis of VaMCI and to further understand the neuropathologic mechanism of its occurrence,which has broad application prospects.In this paper,the research status and new methods of VaMCI are reviewed by using multi-mode magnetic resonance imaging in recent years.
基金supported by the Hong Kong Research Grants Council under grant NO.16202515 and 16212516Guangzhou HKUST Fok Ying Tung Research Institute,China Ministry of Science and Technology TCM Special Research Projects Program under grant No.200807011,No.201007002 and No.201407001-8+2 种基金Beijing Science and Technology Program under grant No.Z111107056811040Beijing New Medical Discipline Development Program under grant No.XK100270569Project of Beijing University of Chinese Medicine under grant No.2011-CXTD-23
文摘OBJECTIVE： To treat patients with vascular mild cognitive impairment （VMCI） using traditional Chinese medicine （TCM）, it is necessary to classify the patients into TCM syndrome types and to apply different treatments to different types. In this paper, we investigate how to properly carry out the classification for patients with VMCI aged 50 or above using a novel data-driven method known as latent tree analysis （LTA）. METHOD： A cross-sectional survey on VMCI was carried out in several regions in Northern China between February 2008 and February 2012 which resulted in a data set that involves 803 patients and 93 symptoms. LTA was performed on the data to reveal symptom co-occurrence patterns, and the patients were partitioned into clusters in multiple ways based on the patterns. The patient clusters were matched up with syndrome types, and population statistics of the clusters are used to quantify the syndrome types and to establish classification rules. RESULTS： Eight syndrome types are identified： Qi deficiency, Qi stagnation, Blood deficiency, Blood stasis, Phlegm-dampness, Fire-heat, Yang deficiency, and Yin deficiency. The prevalence and symptom occurrence characteristics of each syndrome type are determined. Quantitative classification rules are established for determining whether a patient belongs to each of the syndrome types. CONCLUSION： A solution for the TCM syndrome classification problem for patients with VMCI and aged 50 or above is established based on the LTA of unlabeled symptom survey data. The results can be used as a reference in clinic practice to improve the quality of syndrome differentiation and to reduce diagnosis variances across physicians. They can also be used for patient selection in research projects aimed at finding biomarkers for the syndrome types and in randomized control trials aimed at determining the efficacy of TCM treatments of VMCI.
基金supported by the Natural Science Foundation of Tianjin Municipal Science and Technology Commission(18JCQNJC10900)Tianjin Natural Science Foundation(17JCZDJC36300)。
文摘Subcortical vascular mild cognitive impairment(svMCI)is a common prodromal stage of vascular dementia.Although mounting evidence has suggested abnormalities in several single brain network metrics,few studies have explored the consistency between functional and structural connectivity networks in svMCI.Here,we constructed such networks using resting-state f MRI for functional connectivity and diffusion tensor imaging for structural connectivity in 30 patients with svMCI and 30 normal controls.The functional networks were then parcellated into topological modules,corresponding to several well-defined functional domains.The coupling between the functional and structural networks was finally estimated and compared at the multiscale network level(whole brain and modular level).We found no significant intergroup differences in the functional–structural coupling within the whole brain;however,there was significantly increased functional–structural coupling within the dorsal attention module and decreased functional–structural coupling within the ventral attention module in the svMCI group.In addition,the svMCI patients demonstrated decreased intramodular connectivity strength in the visual,somatomotor,and dorsal attention modules as well as decreased intermodular connectivity strength between several modules in the functional network,mainly linking the visual,somatomotor,dorsal attention,ventral attention,and frontoparietal control modules.There was no significant correlation between the altered module-level functional–structural coupling and cognitive performance in patients with svMCI.These findings demonstrate for the first time that svMCI is reflected in a selective aberrant topological organization in multiscale brain networks and may improve our understanding of the pathophysiological mechanisms underlying svMCI.
文摘目的:探讨不同部位脑白质高信号及脑小血管病负荷积分与血管性轻度认知障碍的相关性。方法:选取2020年8月—12月中关村医院门诊及康复病房收治的血管性轻度认知障碍患者14例,设为VaMCI组;正常组12例。采用MRI扫描技术,利用脑医生平台统计患者不同部位脑白质高信号数目,采用简易精神状态检查(Mini-Mental State Examination,MMSE)和蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评定受试者认知功能,并对所有患者的MRI图像进行脑小血管病负荷评分。结果:VaMCI组白质高信号总数目、皮层下白质高信号数目及CSVD负荷积分与正常组差异有统计学意义(P<0.05)。VaMCI组脑室周白质高信号数目与正常组差异无统计学意义(P>0.05)。MMSE、MoCA评分与白质高信号总数目、皮层下白质高信号数目及CSVD负荷积分存在负相关性。年龄与白质高信号总数目、皮层下白质高信号数目及CSVD负荷积分存在正相关性。结论:血管性轻度认知障碍患者脑白质高信号部位以皮层下为主,结合脑小血管病负荷积分可预测认知功能下降。
