Specific Anatomic Associations Between White Matter Integrity and Cognitive Reserve in Normal and Cognitively Impaired Elders
Specific Anatomic Associations Between White Matter Integrity and Cognitive Reserve in Normal and Cognitively Impaired Elders
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DOI：
10.1097/jgp.0b013e3181e448e1
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发表时间：
2011-01-01
影响因子：
7.2
通讯作者：
Bartres-Faz, David
中科院分区：
文献类型：
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作者：
Arenaza-Urquijo, Eider M.;Bosch, Beatriz;Bartres-Faz, David
目的：探讨健康老年人（HE）、遗忘性轻度认知障碍（a-MCI）和阿尔茨海默病（AD）的白质（WM）完整性和认知储备（CR）之间的关系。作者研究了显示WM年龄相关效应或病理变化的区域的CR和WM完整性之间的相关性，并测试了组间斜率的差异。方法：对18例年轻人、15例HE、16例a-MCI和15例AD患者进行弥散张量图像（DTIs）检测。采用基于图的空间统计方法对DTI数据进行处理。定义了与衰老相关的分数各向异性（FA）萎缩（HE < young）和病理相关的FA网络“（AD < HE）”的区域。CR和WM完整性之间的相关性根据年龄、性别、记忆表现和脑容量进行调整。结果：与a-MCI和AD患者相比，HE患者在胼胝体属等年龄相关区域的CR和WM完整性呈负相关。然而，这些结果是由记忆功能和脑容量的正常变异介导的。对于a-MCI患者，CR和FA在几个主要尿路中呈负相关，比AD组更为明显。虽然纵向结果需要谨慎解释，因为MCI患者的样本减少了，但经过2年的随访，所有进展为AD的患者都有高CR评分，这表明WM完整性降低（高CR患者最大）与进展为AD的风险之间可能存在联系。结论：在HE和a-MCI患者的不同解剖WM区域存在CR相关性。高CR的健康老年人可能对典型年龄相关的WM完整性影响表现出更好的耐受性；在a-MCI患者中，这种关联可能反映了应对早期脑损伤的能力增强。（老年精神病学杂志2010；19:33-42）
Objectives: To investigate the associations between white matter (WM) integrity and cognitive reserve (CR) in healthy elders (HE), amnestic mild cognitive impairment (a-MCI), and Alzheimer's disease (AD). The authors studied correlations between CR and WM integrity in regions showing WM age-related effects or pathologic changes and tested the differences of slopes between groups. Methods: Diffusion tensor images (DTIs) were obtained from 18 young individuals, 15 HE, 16 a-MCI cases, and 15 AD cases. Tract-based spatial statistics was used to process DTI data. Areas showing agerelated fractional anisotropy (FA) shrinkages (HE < young) and pathology-related FA network "(AD < HE)" were defined. Correlations between CR and WM integrity were adjusted for age, gender, memory performance and brain volumes. Results: HE presented more negative correlations between CR and WM integrity than patients with a-MCI and AD in age-related areas, such as the genum of the corpus callosum. However, these results were mediated by normal variability in memory function and brain volumes. For patients with a-MCI, negative associations between CR and FA were found in several major tracts, being more robust than in AD group. Although longitudinal results need to be interpreted with caution because of the reduced sample of patients with MCI, after 2 years of follow-up, all patients who progressed to AD had high-CR scores, suggesting a putative link between reduced WM integrity (maximal in patients with high CR) and risk of progression to AD. Conclusions: CR correlates are implemented in different anatomic WM areas in HE and patients with a-MCI. Healthy elders with high CR may present better tolerance of typical age-related effects on WM integrity; in patients with a-MCI, the association may reflect increased capacity to cope with incipient cerebral damage. (Am J Geriatr Psychiatry 2010; 19:33-42)