Perivascular space(PVS) is a crevice between two slices of cerebral pia maters,filled with tissue fluid,which be formed by pia mater emboling in the surrounding of cerebral perforating branch(excluding micrangium). No...Perivascular space(PVS) is a crevice between two slices of cerebral pia maters,filled with tissue fluid,which be formed by pia mater emboling in the surrounding of cerebral perforating branch(excluding micrangium). Normal PVS(diameter < 2 mm) can be found in almost all healthy adults; however enlarged PVS(diameter > 2 mm) has correlation with neurological disorders probably. The article reviews the formation mechanism,imageology characteristics and the relation with neurological disorders of PVS,which...展开更多
Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension a...Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.展开更多
BACKGROUND Dysfunction of the glymphatic system in the brain in different stages of altered glucose metabolism and its influencing factors are not well characterized.AIM To investigate the function of the glymphatic s...BACKGROUND Dysfunction of the glymphatic system in the brain in different stages of altered glucose metabolism and its influencing factors are not well characterized.AIM To investigate the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states,the present study employed diffusion tensor imaging along the perivascular space(DTI-ALPS)index.METHODS Sample size was calculated using the pwr package in R software.This crosssectional study enrolled 22 patients with normal glucose metabolism(NGM),20 patients with prediabetes,and 22 patients with type 2 diabetes mellitus(T2DM).A 3.0T magnetic resonance imaging was used to evaluate the function of the glymphatic system.The mini-mental state examination(MMSE)was used to assess general cognitive function.The DTI-ALPS index of bilateral basal ganglia and the mean DTI-ALPS index was calculated.Further,the correlation between DTI-ALPS and clinical features was assessed.RESULTS The left-side,right-side,and mean DTI-ALPS index in the T2DM group were significantly lower than that in the NGM group.The right-side DTI-ALPS and mean DTI-ALPS index in the T2DM group were significantly lower than those in the prediabetes group.DTI-ALPS index lateralization was not observed.The MMSE score in the T2DM group was significantly lower than that in the NGM and prediabetes group.After controlling for sex,the left-side DTI-ALPS and mean DTI-ALPS index in the prediabetes group were positively correlated with 2-hour postprandial blood glucose level;the left-side DTI-ALPS index was negatively correlated with total cholesterol and low-density lipoprotein level.The right-side DTI-ALPS and mean DTI-ALPS index were negatively correlated with the glycosylated hemoglobin level and waist-to-hip ratio in the prediabetes group.The left-side,right-side,and mean DTI-ALPS index in the T2DM group were positively correlated with height.The left-side and mean DTIALPS index in the T2DM group were negatively correlated with high-density lipoprotein levels.CONCLUSION Cerebral glymphatic system dysfunction may mainly occur in the T2DM stage.Various clinical variables were found to affect the DTI-ALPS index in different glucose metabolism states.This study enhances our understanding of the pathophysiology of diabetic brain damage and provides some potential biological evidence for its early diagnosis.展开更多
The glymphatic system is a relatively recently identified fluid exchange and transpo rt system in the brain.Accumulating evidence indicates thatglymphatic function is impaired not only in central nervous system disord...The glymphatic system is a relatively recently identified fluid exchange and transpo rt system in the brain.Accumulating evidence indicates thatglymphatic function is impaired not only in central nervous system disorders but also in systemic diseases.Systemic diseases can trigger the inflammatory responses in the central nervous system,occasionally leading to sustained inflammation and functional disturbance of the central nervous system.This review summarizes the current knowledge on the association between glymphatic dysfunction and central nervous system inflammation.In addition,we discuss the hypothesis that disease conditions initially associated with peripheral inflammation ove rwhelm the performance of the glymphatic system,thereby triggering central nervous system dysfun ction,chronic neuroinflammation,and neurodegeneration.Future research investigating the role of the glymphatic system in neuroinflammation may offer innovative therapeutic approaches for central nervous system disorders.展开更多
In this article,we comment on an original article published in a recent issue of the World Journal of Diabetes.That observational cross-sectional study focused on investigating the function of the glymphatic system an...In this article,we comment on an original article published in a recent issue of the World Journal of Diabetes.That observational cross-sectional study focused on investigating the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states by using diffusion tensor imaging along the perivascular space(DTI-ALPS)index.It was shown that the cerebral glymphatic system may be dysfunctional in patients with type 2 diabetes.Various clinical variables affected the DTI-ALPS index in different glucose metabolism states.In conclusion,the study by Tian et al improves the under-standing of the pathophysiology of diabetes-associated brain damage and pro-vides insights for early diagnosis.展开更多
脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔...脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。展开更多
类淋巴系统(glymphatic system,GS)是大脑中废物清除的途径,其功能受损可以通过沿血管周围间隙扩散张量成像分析(diffusion tensor imaging analysis along the perivascular space,DTI-ALPS)进行评估。目前,DTI-ALPS作为一种非侵入性...类淋巴系统(glymphatic system,GS)是大脑中废物清除的途径,其功能受损可以通过沿血管周围间隙扩散张量成像分析(diffusion tensor imaging analysis along the perivascular space,DTI-ALPS)进行评估。目前,DTI-ALPS作为一种非侵入性方法已被广泛用于评估神经系统疾病中的GS功能改变,它在评估神经系统疾病的病程进展、认知障碍及预测预后等方面发挥了举足轻重的作用。本文就GS、DTI-ALPS方法与应用优势及其在神经系统疾病中的应用进行综述,旨在为神经系统疾病的病程进展、预测影响预后因素以及临床治疗疗效方面提供一定的参考。展开更多
目的探讨近期皮质下小梗死(RSSI)患者颅内深髓静脉(DMV)可见性与不同区域血管周围间隙扩大(EPVS)及认知功能的相关性。方法回顾性连续纳入南京医科大学附属常州市第二人民医院神经内科自2022年10月至2023年10月收治的RSSI患者,所有患者...目的探讨近期皮质下小梗死(RSSI)患者颅内深髓静脉(DMV)可见性与不同区域血管周围间隙扩大(EPVS)及认知功能的相关性。方法回顾性连续纳入南京医科大学附属常州市第二人民医院神经内科自2022年10月至2023年10月收治的RSSI患者,所有患者入院后3 d内完成MR的常规及磁敏感加权成像(SWI)序列扫描。所有RSSI患者发病7 d内进行蒙特利尔认知评估(MoCA)量表评分。对所有患者基底节区(BG)和半卵圆中心区的EPVS进行分级评估和体积测量,使用DMV视觉评分对患者SWI幅度图或最小强度投影图上的DMV可见性进行评估,并将患者分为可见性较高的DMV低-中分组(评分0~12分,104例)及可见性较低的DMV高分组(评分13~18分,47例),采用单因素分析比较两组患者的临床和影像学资料,采用多因素Logistic回归和Spearman相关分析方法分析DMV可见性与BG-EPVS分级及体积的关系以及其与患者认知功能的关系。结果共纳入RSSI患者151例,平均年龄(69±10)岁,其中男92例(60.9%),女59例(39.1%)。DMV高分组RSSI患者的年龄[(76±5)岁比(65±10)岁,t=-10.875]、高血压病患者比例[78.7%(37/47)比54.8%(57/104),χ^(2)=7.879]、BG-EPVS分级、BG-EPVS体积[5.67(5.30,5.81)ln mm 3比4.61(3.66,5.30)ln mm 3,Z=-6.772]、脑白质高信号体积[7.67(6.23,8.43)ln mm 3比4.31(3.53,5.89)ln mm 3,Z=-6.501]均明显高于DMV低-中分组,差异均有统计学意义(均P<0.05)。DMV高分组RSSI患者的总胆固醇[3.74(3.20,4.39)mmol/L比4.09(3.47,4.96)mmol/L,Z=-2.082]、三酰甘油[1.20(0.78,1.86)mmol/L比1.53(1.05,1.99)mmol/L,Z=-2.343]、MoCA量表评分[21.0(20.0,22.0)分比24.0(22.0,25.0)分,Z=-9.862]均低于DMV低-中分组(均P<0.05)。其余基线资料差异均无统计学意义(均P>0.05)。多因素Logistic回归分析结果显示,较高的年龄(OR=1.181,95%CI:1.070~1.304,P=0.001)、中重度BG-EPVS(OR=2.441,95%CI:1.186~5.024,P=0.015)、较高的BG-EPVS体积(OR=4.987,95%CI:1.218~19.350,P=0.020)和较高的WMH体积(OR=1.285,95%CI:1.044~1.582,P=0.018)与较高的DMV评分相关。Spearman相关性分析结果显示,DMV评分与RSSI患者的BG-EPVS分级呈正相关(r=0.613,P<0.01),与BG-EPVS体积呈正相关(r=0.549,P<0.01),与RSSI患者的MoCA量表评分呈负相关(r=-0.449,P<0.01)。结论年龄、BG-EPVS分级、BG-EPVS体积和WMH体积与RSSI患者的DMV可见性相关;RSSI患者DMV的可见性越差,认知功能损伤越严重。展开更多
目的采用7 T MRI研究帕金森病(PD)病人扩大的血管周围间隙(EPVS)与其运动症状的相关性,探讨采用7 T MRI测量的EPVS在PD诊断中的价值。方法前瞻性纳入经临床确诊为PD的病人(PD组)14例,采用PD Hoehn-Yahr分期(H-Y分期)及统一PD评分量表(UP...目的采用7 T MRI研究帕金森病(PD)病人扩大的血管周围间隙(EPVS)与其运动症状的相关性,探讨采用7 T MRI测量的EPVS在PD诊断中的价值。方法前瞻性纳入经临床确诊为PD的病人(PD组)14例,采用PD Hoehn-Yahr分期(H-Y分期)及统一PD评分量表(UPDRS)评估运动症状。同时纳入健康对照者(HC组)17例。2组均行7 T MRI检查,并在T_(2)WI和T_(2)-液体衰减反转恢复(FLAIR)影像上分析半卵圆中心和基底节区EPVS,计数并评分。采用独立样本t检验比较2组间半卵圆中心和基底节区EPVS的数量、评分之间的差异。采用Pearson相关分析评估PD病人半卵圆中心EPVS和基底节区EPVS评分及数量与运动症状评分的相关性。结果PD组的基底节区EPVS数量、半卵圆中心EPVS评分均高于HC组(均P<0.05)。PD病人的H-Y分期与基底节区EPVS数量呈正相关(r=0.242,P<0.001),其他运动症状评分与EPVS数量及评分均无相关性(均P>0.05)。结论7 T MRI上可见PD病人的EPVS比HC的多,且PD病人的运动症状与基底节区EPVS数量呈正相关,7 T MRI上测量的EPVS有可能作为PD的影像学标志物。展开更多
目的通过文献计量学的方法分析2013—2023年血管周围间隙的研究现状、热点及前沿领域。方法在Web of Science核心合集数据库中检索2013年1月1日—2023年6月19日血管周围间隙相关英文论著。使用CiteSpace V6.3.R1软件分析文献的发文国家...目的通过文献计量学的方法分析2013—2023年血管周围间隙的研究现状、热点及前沿领域。方法在Web of Science核心合集数据库中检索2013年1月1日—2023年6月19日血管周围间隙相关英文论著。使用CiteSpace V6.3.R1软件分析文献的发文国家、研究机构、作者的合作网络,参考文献、第一作者、期刊的共被引网络,关键词的共现网络,关键词及参考文献共被引的突现情况;使用VOSviewer 1.6.15软件对关键词进行聚类分析。结果共纳入1549篇文献。2013—2023年的年发文量整体呈增长趋势。美国的发文量最多,其次为中国。发文量位列前3的研究机构分别是哈佛大学、麻省总医院和爱丁堡大学。合作网络分析发现国家间合作相对紧密,国内研究机构与其他研究机构合作较少。爱丁堡大学的Wardlaw Joanna M发文量最多。关键词共现图谱显示前10个高频关键词分别为小血管病、扩大的血管周围间隙、MRI、脑、Virchow-Robin间隙、阿尔茨海默病、痴呆、风险、卒中和类淋巴系统。关键词聚类分析发现脑小血管病、痴呆、MRI为当前研究热点,类淋巴系统为新兴的研究方向。关键词突现分析表明弥散成像从2021年至今备受关注。结论近10年血管周围间隙的研究热度逐年攀升。脑小血管病是主要的研究热点,类淋巴系统为新兴的研究方向,前沿领域为弥散张量成像等MRI技术。展开更多
类淋巴系统(glymphatic system,GS)是近年出现的探究中枢神经系统疾病生理病理机制的新兴角度。研究证实沿血管周围间隙扩散张量分析(diffusion tensor image analysis along the perivascular space,DTI-ALPS)能够有效地评估中枢神经...类淋巴系统(glymphatic system,GS)是近年出现的探究中枢神经系统疾病生理病理机制的新兴角度。研究证实沿血管周围间隙扩散张量分析(diffusion tensor image analysis along the perivascular space,DTI-ALPS)能够有效地评估中枢神经系统疾病患者GS功能改变,尤其是在退行性中枢神经系统疾病,如癫痫、帕金森病、痴呆。本文就应用DTI-ALPS技术评估中枢神经系统疾病患者GS功能的研究现状作一综述,旨在为疾病的神经影像研究提供新方向。展开更多
文摘Perivascular space(PVS) is a crevice between two slices of cerebral pia maters,filled with tissue fluid,which be formed by pia mater emboling in the surrounding of cerebral perforating branch(excluding micrangium). Normal PVS(diameter < 2 mm) can be found in almost all healthy adults; however enlarged PVS(diameter > 2 mm) has correlation with neurological disorders probably. The article reviews the formation mechanism,imageology characteristics and the relation with neurological disorders of PVS,which...
基金supported by the National Natural Science Foundation of China,Nos.82274611 (to LZ),82104419 (to DM)Capital Science and Technology Leading Talent Training Project,No.Z1 91100006119017 (to LZ)+3 种基金Beijing Hospitals Authority Ascent Plan,No.DFL20190803 (to LZ)Cultivation Fund of Hospital Management Center in Beijing,No.PZ2022006 (to DM)R&D Program of Beijing Municipal Education Commission,No.KM202210025017 (to DM)Beijing Gold-Bridge Project,No.ZZ20145 (to DM)。
文摘Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
文摘BACKGROUND Dysfunction of the glymphatic system in the brain in different stages of altered glucose metabolism and its influencing factors are not well characterized.AIM To investigate the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states,the present study employed diffusion tensor imaging along the perivascular space(DTI-ALPS)index.METHODS Sample size was calculated using the pwr package in R software.This crosssectional study enrolled 22 patients with normal glucose metabolism(NGM),20 patients with prediabetes,and 22 patients with type 2 diabetes mellitus(T2DM).A 3.0T magnetic resonance imaging was used to evaluate the function of the glymphatic system.The mini-mental state examination(MMSE)was used to assess general cognitive function.The DTI-ALPS index of bilateral basal ganglia and the mean DTI-ALPS index was calculated.Further,the correlation between DTI-ALPS and clinical features was assessed.RESULTS The left-side,right-side,and mean DTI-ALPS index in the T2DM group were significantly lower than that in the NGM group.The right-side DTI-ALPS and mean DTI-ALPS index in the T2DM group were significantly lower than those in the prediabetes group.DTI-ALPS index lateralization was not observed.The MMSE score in the T2DM group was significantly lower than that in the NGM and prediabetes group.After controlling for sex,the left-side DTI-ALPS and mean DTI-ALPS index in the prediabetes group were positively correlated with 2-hour postprandial blood glucose level;the left-side DTI-ALPS index was negatively correlated with total cholesterol and low-density lipoprotein level.The right-side DTI-ALPS and mean DTI-ALPS index were negatively correlated with the glycosylated hemoglobin level and waist-to-hip ratio in the prediabetes group.The left-side,right-side,and mean DTI-ALPS index in the T2DM group were positively correlated with height.The left-side and mean DTIALPS index in the T2DM group were negatively correlated with high-density lipoprotein levels.CONCLUSION Cerebral glymphatic system dysfunction may mainly occur in the T2DM stage.Various clinical variables were found to affect the DTI-ALPS index in different glucose metabolism states.This study enhances our understanding of the pathophysiology of diabetic brain damage and provides some potential biological evidence for its early diagnosis.
基金supported by the National Natural Science Foundation of China,Nos.82071249 and 81771207 (both to CH)。
文摘The glymphatic system is a relatively recently identified fluid exchange and transpo rt system in the brain.Accumulating evidence indicates thatglymphatic function is impaired not only in central nervous system disorders but also in systemic diseases.Systemic diseases can trigger the inflammatory responses in the central nervous system,occasionally leading to sustained inflammation and functional disturbance of the central nervous system.This review summarizes the current knowledge on the association between glymphatic dysfunction and central nervous system inflammation.In addition,we discuss the hypothesis that disease conditions initially associated with peripheral inflammation ove rwhelm the performance of the glymphatic system,thereby triggering central nervous system dysfun ction,chronic neuroinflammation,and neurodegeneration.Future research investigating the role of the glymphatic system in neuroinflammation may offer innovative therapeutic approaches for central nervous system disorders.
基金Supported by European Union-Next Generation EU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘In this article,we comment on an original article published in a recent issue of the World Journal of Diabetes.That observational cross-sectional study focused on investigating the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states by using diffusion tensor imaging along the perivascular space(DTI-ALPS)index.It was shown that the cerebral glymphatic system may be dysfunctional in patients with type 2 diabetes.Various clinical variables affected the DTI-ALPS index in different glucose metabolism states.In conclusion,the study by Tian et al improves the under-standing of the pathophysiology of diabetes-associated brain damage and pro-vides insights for early diagnosis.
文摘脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。
文摘类淋巴系统(glymphatic system,GS)是大脑中废物清除的途径,其功能受损可以通过沿血管周围间隙扩散张量成像分析(diffusion tensor imaging analysis along the perivascular space,DTI-ALPS)进行评估。目前,DTI-ALPS作为一种非侵入性方法已被广泛用于评估神经系统疾病中的GS功能改变,它在评估神经系统疾病的病程进展、认知障碍及预测预后等方面发挥了举足轻重的作用。本文就GS、DTI-ALPS方法与应用优势及其在神经系统疾病中的应用进行综述,旨在为神经系统疾病的病程进展、预测影响预后因素以及临床治疗疗效方面提供一定的参考。
文摘目的探讨近期皮质下小梗死(RSSI)患者颅内深髓静脉(DMV)可见性与不同区域血管周围间隙扩大(EPVS)及认知功能的相关性。方法回顾性连续纳入南京医科大学附属常州市第二人民医院神经内科自2022年10月至2023年10月收治的RSSI患者,所有患者入院后3 d内完成MR的常规及磁敏感加权成像(SWI)序列扫描。所有RSSI患者发病7 d内进行蒙特利尔认知评估(MoCA)量表评分。对所有患者基底节区(BG)和半卵圆中心区的EPVS进行分级评估和体积测量,使用DMV视觉评分对患者SWI幅度图或最小强度投影图上的DMV可见性进行评估,并将患者分为可见性较高的DMV低-中分组(评分0~12分,104例)及可见性较低的DMV高分组(评分13~18分,47例),采用单因素分析比较两组患者的临床和影像学资料,采用多因素Logistic回归和Spearman相关分析方法分析DMV可见性与BG-EPVS分级及体积的关系以及其与患者认知功能的关系。结果共纳入RSSI患者151例,平均年龄(69±10)岁,其中男92例(60.9%),女59例(39.1%)。DMV高分组RSSI患者的年龄[(76±5)岁比(65±10)岁,t=-10.875]、高血压病患者比例[78.7%(37/47)比54.8%(57/104),χ^(2)=7.879]、BG-EPVS分级、BG-EPVS体积[5.67(5.30,5.81)ln mm 3比4.61(3.66,5.30)ln mm 3,Z=-6.772]、脑白质高信号体积[7.67(6.23,8.43)ln mm 3比4.31(3.53,5.89)ln mm 3,Z=-6.501]均明显高于DMV低-中分组,差异均有统计学意义(均P<0.05)。DMV高分组RSSI患者的总胆固醇[3.74(3.20,4.39)mmol/L比4.09(3.47,4.96)mmol/L,Z=-2.082]、三酰甘油[1.20(0.78,1.86)mmol/L比1.53(1.05,1.99)mmol/L,Z=-2.343]、MoCA量表评分[21.0(20.0,22.0)分比24.0(22.0,25.0)分,Z=-9.862]均低于DMV低-中分组(均P<0.05)。其余基线资料差异均无统计学意义(均P>0.05)。多因素Logistic回归分析结果显示,较高的年龄(OR=1.181,95%CI:1.070~1.304,P=0.001)、中重度BG-EPVS(OR=2.441,95%CI:1.186~5.024,P=0.015)、较高的BG-EPVS体积(OR=4.987,95%CI:1.218~19.350,P=0.020)和较高的WMH体积(OR=1.285,95%CI:1.044~1.582,P=0.018)与较高的DMV评分相关。Spearman相关性分析结果显示,DMV评分与RSSI患者的BG-EPVS分级呈正相关(r=0.613,P<0.01),与BG-EPVS体积呈正相关(r=0.549,P<0.01),与RSSI患者的MoCA量表评分呈负相关(r=-0.449,P<0.01)。结论年龄、BG-EPVS分级、BG-EPVS体积和WMH体积与RSSI患者的DMV可见性相关;RSSI患者DMV的可见性越差,认知功能损伤越严重。
文摘目的采用7 T MRI研究帕金森病(PD)病人扩大的血管周围间隙(EPVS)与其运动症状的相关性,探讨采用7 T MRI测量的EPVS在PD诊断中的价值。方法前瞻性纳入经临床确诊为PD的病人(PD组)14例,采用PD Hoehn-Yahr分期(H-Y分期)及统一PD评分量表(UPDRS)评估运动症状。同时纳入健康对照者(HC组)17例。2组均行7 T MRI检查,并在T_(2)WI和T_(2)-液体衰减反转恢复(FLAIR)影像上分析半卵圆中心和基底节区EPVS,计数并评分。采用独立样本t检验比较2组间半卵圆中心和基底节区EPVS的数量、评分之间的差异。采用Pearson相关分析评估PD病人半卵圆中心EPVS和基底节区EPVS评分及数量与运动症状评分的相关性。结果PD组的基底节区EPVS数量、半卵圆中心EPVS评分均高于HC组(均P<0.05)。PD病人的H-Y分期与基底节区EPVS数量呈正相关(r=0.242,P<0.001),其他运动症状评分与EPVS数量及评分均无相关性(均P>0.05)。结论7 T MRI上可见PD病人的EPVS比HC的多,且PD病人的运动症状与基底节区EPVS数量呈正相关,7 T MRI上测量的EPVS有可能作为PD的影像学标志物。
文摘类淋巴系统(glymphatic system,GS)是近年出现的探究中枢神经系统疾病生理病理机制的新兴角度。研究证实沿血管周围间隙扩散张量分析(diffusion tensor image analysis along the perivascular space,DTI-ALPS)能够有效地评估中枢神经系统疾病患者GS功能改变,尤其是在退行性中枢神经系统疾病,如癫痫、帕金森病、痴呆。本文就应用DTI-ALPS技术评估中枢神经系统疾病患者GS功能的研究现状作一综述,旨在为疾病的神经影像研究提供新方向。
