Functional impact of white matter hyperintensities in cognitively normal elderly subjects.
Functional impact of white matter hyperintensities in cognitively normal elderly subjects.
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DOI：
10.1001/archneurol.2010.280
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发表时间：
2010-11
影响因子：
--
通讯作者：
Jack, Clifford R., Jr.
中科院分区：
文献类型：
--
作者：
Murray, Melissa E.;Senjem, Matthew L.;Petersen, Ronald C.;Hollman, John H.;Preboske, Greg M.;Weigand, Stephen D.;Knopman, David S.;Ferman, Tanis J.;Dickson, Dennis W.;Jack, Clifford R., Jr.
研究MRI上检测到的白色高信号（WMH）对非痴呆老年受试者运动功能障碍和认知功能障碍的影响。横断面研究。明尼苏达州奥姆斯特德县认知障碍发病率和患病率的人群研究共有148名非痴呆老年人（65名男性），年龄从73岁到91岁不等。我们测量了在先验定义的大脑区域（即额叶、颞叶、顶叶、枕叶、脑室周围或皮质下）中被分类为WMH（WMHp）的总白色物质体积的百分比。使用统一帕金森氏病评定量表（UNITED PARKINISON'S DISEASE RATING SCALE，简称CARS）对运动技能进行了定性评估，并使用数字化便携式走道系统进行了定量评估。使用记忆、语言、执行功能和视觉空间推理的Z分数评估四个认知领域。除枕叶外，所有区域的WMHp较高与执行功能z评分较低相关（p值<0.01）。所有区域的WMHp较高，但顶叶的WMHp最强，与步态/姿势稳定性/姿势稳定性总和较高相关（p值<0.01）。无论是室周、皮质下还是肺叶，较高的WMHp都与流速降低相关（p值<0.001）。我们的结论是，执行功能是主要的认知领域受WMH负担。这些数据表明，顶叶中的WMH与其他三个脑叶相比主要负责减少平衡和姿势支持，并且可能通过老化大脑中的顶叶功能障碍改变感觉信息的整合。有趣的是，顶叶WM的变化与运动速度并不主要相关，这为神经网络参与步态速度提供了证据。
To investigate the impact white matter hyperintensities (WMH) detected on MRI have on motor dysfunction and cognitive impairment in non-demented elderly subjects. Cross-sectional study. Population-based study on the incidence and prevalence of cognitive impairment in Olmsted County, MN. A total of 148 non-demented elderly (65 males) ranging in age from 73 to 91 years. We measured the percentage of the total white matter volume classified as WMH (WMHp) in a priori defined brain regions (i.e. frontal, temporal, parietal, occipital, periventricular or subcortical). Motor impairment was evaluated qualitatively using the Unified Parkinson’s Disease Rating Scale (UPDRS) summary measures of motor skills and quantitatively using a digitized portable walkway system. Four cognitive domains were evaluated using z-scores of memory, language, executive function, and visuospatial reasoning. A higher WMHp in all regions except occipital was associated with lower executive function z-score (p-value<0.01). A higher WMHp in all regions, but most strongly for parietal lobe, correlated with higher gait/postural-stability/posture UPDRS sum (p-value<0.01). A higher WMHp whether periventricular, subcortical or lobar correlated with reduced velocity (p-value<0.001). We conclude that executive function is the primary cognitive domain affected by WMH burden. The data suggests that WMH in the parietal lobe are chiefly responsible for reduced balance and postural support compared to the other three lobes and may alter integration of sensory information via parietal lobe dysfunction in the aging brain. It is of interest that parietal WM changes were not the predominant correlate with motor speed, lending evidence to a global involvement of neural networks in gait velocity.
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影响因子：
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作者：
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通讯作者：
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Jack, Clifford R., Jr.