It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether t...It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups： without either increased CIMT （I） or carotid plaque （P）： I（-）P（-）; with only increased CIMT： I（＋）P（-）; with only carotid plaque： I（-）P（＋）; and with both increased CIMT and carotid plaque： I（＋）P（＋） The presence and severity of periventricular WMLs （PWMLs） and deep WMLs （DWMLs） were as- sessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I（-）P（-）〈 I（＋）P（-）〈 I（-）P（＋）〈 I（＋）P（＋） （P〈0.0001）. For the pa- tients with DWMLs, the grades of both I（＋）P（-） and I（＋）P（＋） were increased significantly compared to I（-）P（-） （P〈0.0025, P〈0.05, respectively） without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.展开更多
Objective To identify the diffusion alterations of deep gray matter(GM)and white matter(WM)among Alzheimer’s disease(AD),mild cognitive impairment(MCI)and healthy people by atlas-based analysis(ABA),and to investigat...Objective To identify the diffusion alterations of deep gray matter(GM)and white matter(WM)among Alzheimer’s disease(AD),mild cognitive impairment(MCI)and healthy people by atlas-based analysis(ABA),and to investigate the respective relationship with cognitive function.Methods Twenty-one AD patients(AD group),8 MCI patients(MCI group)and展开更多
目的:探讨急性缺血性脑卒中患者脑白质疏松与认知障碍及功能结局的关系。方法:选取哈尔滨医科大学附属第一医院神经内科病房住院治疗的急性缺血性脑卒中患者共100例。采用简易智能精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉...目的:探讨急性缺血性脑卒中患者脑白质疏松与认知障碍及功能结局的关系。方法:选取哈尔滨医科大学附属第一医院神经内科病房住院治疗的急性缺血性脑卒中患者共100例。采用简易智能精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)对其进行认知功能评价,采用美国国立卫生研究院卒中量表(National Institute of Health stroke scale(NIHSS)、改良RANKIN量表(mRs)、日常生活能力量表(BI)评分对其进行功能结局评价。基于Fazekas方法将脑白质疏松分为脑室旁(periventricular hyperintensities,PVH)及深部白质病变deep white matter hyperintensities,DWMH),并分开分级,各分为4级(0~3级),将认知功能评分及功能结局评分与以上白质疏松程度进行相关性分析。结果:PVH阳性组患者的年龄高于对照组,且脑白质疏松程度越严重,年龄越大,差异有统计学意义(P<0.05);PVH和DWMH阳性组患者的MMSE评分、MoCA评分均低于对照组,且脑白质疏松程度越严重,MMSE评分、MoCA评分越低,差异存在统计学意义(P<0.05);PVH和DWMH阳性组患者的NIHSS评分、mRs评分均高于对照组,且脑白质疏松程度越严重,NIHSS评分、mRs评分越高,差异存在统计学意义(P<0.05);PVH和DWMH阳性组患者的BI评分均低于对照组,且脑白质疏松程度越严重,BI评分越低,差异存在统计学意义(P<0.05);PVH和DWMH均与认知功能评分MMSE、MoCA相关,与功能结局评分NIHSS、mRs相关;且前者为负相关,后者为正相关;而且,DWMH与PVH相比,与认知功能及功能结局具有显著的相关。结论:脑白质疏松程度加重,认知功能评分随之下降,功能预后评分随之增加,提示脑白质疏松程度的加重,可作为急性缺血性脑卒中患者认知功能障碍及不良功能预后的预测因素;而且,深部白质病变与侧脑室旁病变相比,与认知功能及功能结局的相关性更大。展开更多
目的探索缺血性深部脑白质损害(deep white matter lesions,DWMLs)患者的认知障碍特征及与不同脑区皮层功能之间的关系。方法纳入2016-2018年我科门诊及住院的轻度缺血性深部脑白质损害患者38名,依据患者有无认知障碍分为认知障碍组及...目的探索缺血性深部脑白质损害(deep white matter lesions,DWMLs)患者的认知障碍特征及与不同脑区皮层功能之间的关系。方法纳入2016-2018年我科门诊及住院的轻度缺血性深部脑白质损害患者38名,依据患者有无认知障碍分为认知障碍组及认知正常组,同时匹配对照组18名(颅脑核磁共振证实未见白质病变且认知功能正常的老年体检人群)。采用神经心理量表及静息态功能磁共振的比率低频振幅值分析深部脑白质损害患者认知障碍的特点以及功能异常的皮层脑区。结果深部脑白质损害患者的执行功能、注意功能、记忆功能和视空间功能均显著降低(P<0.05),其中执行、注意功能损害在认知障碍的早期阶段出现。通过静息态功能核磁共振检查发现:与对照组比较,深部脑白质损害伴认知障碍患者的双侧额中回、双侧楔叶、左侧楔前叶、左侧前扣带回、双侧颞中回、左侧枕颞内侧回的比率低频振幅值降低(P<0.05),同时,左侧海马杏仁核、左侧顶上回、左侧小脑蚓部的比率低频振幅值升高(P<0.05)。与对照组比较,深部脑白质损害认知正常患者的双侧额中回、左侧前扣带回、双侧颞中回的比率低频振幅值降低(P<0.05),无比率低频振幅值明显升高的脑区。Pearson相关性分析发现:上述功能异常脑区均与深部脑白质损害患者的认知障碍具有显著相关性。结论深部脑白质损害可导致执行功能、注意功能、记忆功能和视空间功能下降,其中执行、注意功能下降是深部脑白质损害导致认知障碍的首发症状。缺血性DWMLs患者的多个脑区皮层功能下降,而且与认知障碍相关。皮层功能损害可能是缺血性DWMLs所致认知障碍的原因之一。展开更多
基金supported by the National Natural Science Foundation of China (No. 30970962)
文摘It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups： without either increased CIMT （I） or carotid plaque （P）： I（-）P（-）; with only increased CIMT： I（＋）P（-）; with only carotid plaque： I（-）P（＋）; and with both increased CIMT and carotid plaque： I（＋）P（＋） The presence and severity of periventricular WMLs （PWMLs） and deep WMLs （DWMLs） were as- sessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I（-）P（-）〈 I（＋）P（-）〈 I（-）P（＋）〈 I（＋）P（＋） （P〈0.0001）. For the pa- tients with DWMLs, the grades of both I（＋）P（-） and I（＋）P（＋） were increased significantly compared to I（-）P（-） （P〈0.0025, P〈0.05, respectively） without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.
文摘Objective To identify the diffusion alterations of deep gray matter(GM)and white matter(WM)among Alzheimer’s disease(AD),mild cognitive impairment(MCI)and healthy people by atlas-based analysis(ABA),and to investigate the respective relationship with cognitive function.Methods Twenty-one AD patients(AD group),8 MCI patients(MCI group)and
文摘目的:探讨急性缺血性脑卒中患者脑白质疏松与认知障碍及功能结局的关系。方法:选取哈尔滨医科大学附属第一医院神经内科病房住院治疗的急性缺血性脑卒中患者共100例。采用简易智能精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)对其进行认知功能评价,采用美国国立卫生研究院卒中量表(National Institute of Health stroke scale(NIHSS)、改良RANKIN量表(mRs)、日常生活能力量表(BI)评分对其进行功能结局评价。基于Fazekas方法将脑白质疏松分为脑室旁(periventricular hyperintensities,PVH)及深部白质病变deep white matter hyperintensities,DWMH),并分开分级,各分为4级(0~3级),将认知功能评分及功能结局评分与以上白质疏松程度进行相关性分析。结果:PVH阳性组患者的年龄高于对照组,且脑白质疏松程度越严重,年龄越大,差异有统计学意义(P<0.05);PVH和DWMH阳性组患者的MMSE评分、MoCA评分均低于对照组,且脑白质疏松程度越严重,MMSE评分、MoCA评分越低,差异存在统计学意义(P<0.05);PVH和DWMH阳性组患者的NIHSS评分、mRs评分均高于对照组,且脑白质疏松程度越严重,NIHSS评分、mRs评分越高,差异存在统计学意义(P<0.05);PVH和DWMH阳性组患者的BI评分均低于对照组,且脑白质疏松程度越严重,BI评分越低,差异存在统计学意义(P<0.05);PVH和DWMH均与认知功能评分MMSE、MoCA相关,与功能结局评分NIHSS、mRs相关;且前者为负相关,后者为正相关;而且,DWMH与PVH相比,与认知功能及功能结局具有显著的相关。结论:脑白质疏松程度加重,认知功能评分随之下降,功能预后评分随之增加,提示脑白质疏松程度的加重,可作为急性缺血性脑卒中患者认知功能障碍及不良功能预后的预测因素;而且,深部白质病变与侧脑室旁病变相比,与认知功能及功能结局的相关性更大。
文摘目的探索缺血性深部脑白质损害(deep white matter lesions,DWMLs)患者的认知障碍特征及与不同脑区皮层功能之间的关系。方法纳入2016-2018年我科门诊及住院的轻度缺血性深部脑白质损害患者38名,依据患者有无认知障碍分为认知障碍组及认知正常组,同时匹配对照组18名(颅脑核磁共振证实未见白质病变且认知功能正常的老年体检人群)。采用神经心理量表及静息态功能磁共振的比率低频振幅值分析深部脑白质损害患者认知障碍的特点以及功能异常的皮层脑区。结果深部脑白质损害患者的执行功能、注意功能、记忆功能和视空间功能均显著降低(P<0.05),其中执行、注意功能损害在认知障碍的早期阶段出现。通过静息态功能核磁共振检查发现:与对照组比较,深部脑白质损害伴认知障碍患者的双侧额中回、双侧楔叶、左侧楔前叶、左侧前扣带回、双侧颞中回、左侧枕颞内侧回的比率低频振幅值降低(P<0.05),同时,左侧海马杏仁核、左侧顶上回、左侧小脑蚓部的比率低频振幅值升高(P<0.05)。与对照组比较,深部脑白质损害认知正常患者的双侧额中回、左侧前扣带回、双侧颞中回的比率低频振幅值降低(P<0.05),无比率低频振幅值明显升高的脑区。Pearson相关性分析发现:上述功能异常脑区均与深部脑白质损害患者的认知障碍具有显著相关性。结论深部脑白质损害可导致执行功能、注意功能、记忆功能和视空间功能下降,其中执行、注意功能下降是深部脑白质损害导致认知障碍的首发症状。缺血性DWMLs患者的多个脑区皮层功能下降,而且与认知障碍相关。皮层功能损害可能是缺血性DWMLs所致认知障碍的原因之一。
