Relationship between the severity of cerebral white matter hyperintensities and sympathetic nervous activity in older adults
Relationship between the severity of cerebral white matter hyperintensities and sympathetic nervous activity in older adults
复制标题
老年人脑白质高信号严重程度与交感神经活动的关系
DOI：
10.1111/ggi.13217
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发表时间：
2017
影响因子：
3.3
通讯作者：
Kozaki Koichi
中科院分区：
文献类型：
--
作者：
Obara Toshimasa;Nagai Kumiko;Shibata Shigeki;Hirasawa Ai;Koshiba Hitomi;Hasegawa Hiroshi;Ebihara Takae;Kozaki Koichi
目的脑部磁共振成像显示的脑白质高信号(WMH)是一种与老年综合征发生发展相关的异常现象。最近发现，交感神经活动不足可能与老年人的身体和认知功能障碍有关。因此，我们调查了脑白质血肿的严重程度和交感神经活动之间的关系，通过心率变异性来衡量。动态心电图记录30min。根据心电图上的RR间期，计算正常到正常间期的标准差、整个记录的所有五个节段的正常到正常间期的标准差、低频(LF)、高频(HF)和LF/HF的标准差。脑室周围高信号和深部白质高信号按Fazekas分级。根据Junque(脑室周围高信号)和De Got(DWMH)方法对WMH进行半定量评分。结果LF/HF与全脑室周围高信号、局部高信号及DWMH呈显著负相关。多元回归分析显示，低频/高频与DWMH(总的、颞叶的、枕叶的)之间仍然存在显著的负相关。结论DWMH的严重程度与LF/HF和老年综合征之一的跌倒风险相关，提示WMH、交感神经功能障碍和老年综合征是相互关联的。
AimWhite matter hyperintensities (WMH), visualized on brain magnetic resonance imaging, represent an abnormality related to the development of geriatric syndromes. Recently, it has been found that low sympathetic nervous activity might be associated with physical and cognitive dysfunction in older adults. Therefore, we investigated the relationship between the severity of cerebral WMH and sympathetic nervous activity, measured by the heart rate variability.MethodsWe carried out a cross‐sectional study of 39 older patients. Holter recording was carried out for 30 min. From the RR intervals on the electrocardiogram, the standard deviation of the normal‐to‐normal intervals, the standard deviation of all normal‐to‐normal intervals in all the five segments of the entire recording, low frequency (LF), high frequency (HF) and LF/HF were calculated. In regard to the WMH, periventricular hyperintensities and deep white matter hyperintensities (DWMH) were rated according to the Fazekas classification. The WMH were also rated semiquantitatively according to the methods developed by Junque (periventricular hyperintensities) and de Groot (DWMH).ResultsThe LF/HF showed significant negative correlations with the total and regional periventricular hyperintensities, as well as DWMH. Multiple regression analysis showed that the negative associations remained significant between the LF/HF and DWMH (total, temporal, occipital). Furthermore, fall risk index significantly correlated with the LF/HF, total and the occipital DWMH.ConclusionsThe severity of the DWMH was associated with the LF/HF and the fall risk, one of the important geriatric syndromes, suggesting that WMH, sympathetic nervous dysfunction and geriatric syndrome are interrelated to each other.Geriatr Gerontol Int 2018; 18: 569–575.