Silent brain infarction on magnetic resonance imaging and neurological abnormalities in community-dwelling older adults - The Cardiovascular Health Study
Silent brain infarction on magnetic resonance imaging and neurological abnormalities in community-dwelling older adults - The Cardiovascular Health Study
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DOI：
10.1161/01.str.28.6.1158
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发表时间：
1997-06-01
期刊：
影响因子：
8.3
通讯作者：
OLeary, DH
中科院分区：
文献类型：
--
作者：
Price, TR;Manolio, TA;OLeary, DH
背景和目的在有症状和无症状的老年人进行脑MRI检查时经常发现梗死样病变，但其在老年人中的意义尚未得到研究。我们以年龄大于或等于65岁的男性和女性为样本，确定了MRI梗死的患病率，并将这些发现与人口统计学、认知和神经系统状况联系起来。方法对3660名心血管健康研究（CHS）参与者进行简短的神经学检查和认知功能测试后进行MRI扫描。mri集中读取直径大于或等于3mm的梗死灶或较小的梗死样病变。结果3647名可读梗死信息的参与者中有1131人（31%）检测到MRI梗死，3397名亚组参与者中有961人（28%）没有已知卒中（“无症状”MRI梗死）。2516名没有MRI梗死大于或等于3mm的参与者中有196人发现较小的梗死样病变。MRI梗死更常见于年龄较大、有中风史、认知受损、视野缺陷、手指重复敲击缓慢（均P < 0.0001）、脚趾和脚跟行走无力、有记忆丧失、昏迷或偏头痛史的参与者。对无卒中史的患者进行多变量分析显示，无症状MRI梗死与年龄较大、偏头痛史、手指符号评分较低以及神经学检查异常有很强的相关性。结论MRI证明脑梗死在无脑卒中临床史的老年男性和女性中是常见的。它们与认知障碍和神经缺陷的强烈联系表明，它们既不是沉默的，也不是无害的。
Background and Purpose Infarctlike lesions are frequently detected in symptomatic and asymptomatic older persons undergoing cerebral MRI, but their significance in older adults has not been examined. We determined the prevalence of MRI infarcts in a population-based sample of men and women aged greater than or equal to 65 years and related these findings to demographic, cognitive, and neurological status.Methods MRI scanning was performed in 3660 Cardiovascular Health Study (CHS) participants after brief neurological examinations and tests of cognitive function. MRIs were read centrally for the presence of an infarct greater than or equal to 3 mm in diameter or smaller infarctlike lesions.Results MRI infarcts were detected in 1131 of 3647 participants with readable infarct information (31%) and in 961 of the subgroup of 3397 participants (28%) without known prior stroke (''silent'' MRI infarcts). Smaller infarctlike lesions were found in 196 of 2516 participants who had no MRI infarcts greater than or equal to 3 mm. MRI infarcts were more common in participants who were older, had prior stroke, impaired cognition, visual field deficits, slowed repetitive finger tapping (all P < .0001), weakness on toe and heel walking, and history of memory loss, coma, or migraine headaches. Multivariate analysis in those without prier stroke showed strong associations of silent MRI infarcts with older age, history of migraines, lower digit symbol scores, and more abnormalities on neurological examination.Conclusions MRI evidence of brain infarction is common in older men and women without a clinical history of stroke. Their strong associations with impaired cognition and neurological deficits suggest that they are neither silent nor innocuous.