Associations of White Matter Hyperintensities with Cognitive Decline: A Longitudinal Study
Associations of White Matter Hyperintensities with Cognitive Decline: A Longitudinal Study
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白质高信号与认知衰退的关联：一项纵向研究
DOI：
10.3233/jad-191005
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发表时间：
2020-01-01
影响因子：
4
通讯作者：
Yu, Jin-Tai
中科院分区：
文献类型：
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作者：
Wang, Yan-Li;Chen, Wei;Yu, Jin-Tai
白色高信号（WMH）主要由脑血管损伤引起，可导致认知功能障碍。为了确定WMH的数量是否与多年来的认知下降有关，这项纵向研究涉及2010年8月至2017年5月ADNI-2数据集中的818名个体。采用简易精神状态检查量表（MMSE）、蒙特利尔认知评定量表（莫卡）、临床痴呆评定量表（CDRSB）、阿尔茨海默病认知评定量表（AD）、认知功能评定量表（ADAS-Cog 13）、Rey听觉言语学习测试（RAVLT）、功能评估问卷（FAQ）、执行功能（ADNI-EF）、和记忆功能（ADNI-Mem）。采用多元线性回归模型、线性混合模型、斯皮尔曼等级相关和Kaplan-Meier生存曲线进行相关性分析。基线时，阿尔茨海默病（AD）痴呆患者的WMH体积大于对照组（p < 0.001）和轻度认知障碍（p = 0.006）患者。WMH的体积越大，ADAS-Cog 13和ADNI-EF的性能越差（p = 0.029; p = 0.003）和MMSE、莫卡、CDRSB、ADAS-Cog 13、FAQ和ADNI-Mem（总体p < 0.05）。WMH的变化率与MMSE、莫卡、CDRSB、FAQ、ADNI-EF、ADNI-Mem的变化率之间的相关性有统计学意义。此外，具有高WMH体积的患者显示出痴呆的可能性增加。研究结果表明，WMH体积与认知能力下降有关，并且有助于向AD的转化。
White matter hyperintensities (WMHs), mainly caused by cerebrovascular injury, may lead to cognitive impairment. In order to identify whether the volume of WMHs is associated with cognitive decline over years, this longitudinal study involved 818 individuals from the ADNI-2 dataset from August 2010 to May 2017. Cross-sectional and longitudinal associations of WMHs with 8 cognitive domains were explored, using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating Sum of Boxes (CDRSB), Alzheimer Disease Assessment Scale-Cognitive (ADAS-Cog13), Rey Auditory Verbal Learning Test (RAVLT), Functional Assessment Questionnaire (FAQ), executive function (ADNI-EF), and memory function (ADNI-Mem). The association analyses were performed using multiple linear regression models, linear mixed models, Spearman rank correlation, and Kaplan-Meier survival curves. The volumes of WMHs were greater in patients with Alzheimer's disease (AD) dementia compared with controls (p < 0.001) and mild cognitive impairment (p = 0.006) patients at baseline. The bigger volumes of WMHs correlated with worse performances on ADAS-Cog13 and ADNI-EF (p = 0.029; p = 0.003) at baseline and MMSE, MoCA, CDRSB, ADAS-Cog13, FAQ, and ADNI-Mem (overall p < 0.05) longitudinally, after adjusting for age, sex, educational level, apolipoprotein E e4 genotype, hypertension, hyperlipidemia, diabetes, smoking, infarction, and diagnosis. Additionally, the correlations between the change rate of WMHs and change rates of MMSE, MoCA, CDRSB, FAQ, ADNI-EF, and ADNI-Mem were statistically significant. Furthermore, patients with high WMH volumes showed an increased likelihood of dementia. The results of the study suggest that WMH volume is associated with cognitive decline, and it contributes to the conversion to AD.