Mild cognitive impairment after lacunar infarction:: Voxel-based morphometry and neuropsychological assessment
Mild cognitive impairment after lacunar infarction:: Voxel-based morphometry and neuropsychological assessment
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DOI：
10.1159/000099134
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发表时间：
2007-01-01
影响因子：
2.9
通讯作者：
Junque, Carme
中科院分区：
文献类型：
--
作者：
Grau-Olivares, Marta;Bartres-Faz, David;Junque, Carme
背景：本研究的目的是探讨伴或不伴血管型轻度认知障碍（MCI-V）的腔隙性梗死患者的神经放射学特征（包括白质病变和灰质体积）是否存在差异。方法：对 40 例脑卒中后 1 个月内的腔隙性脑梗死患者进行研究。结果：22名患者出现MCI-V，与无认知障碍的患者相比，这些患者年龄明显较大，受正规教育的年限也较少。 MCI-V 组的 MRI 皮层下高信号尤其是基底神经节（壳核和丘脑）的发生率明显更高。在基于体素的形态测量研究中，MCI-V 患者的颞中回、左右额叶和后双侧枕顶区（包括后扣带回）和小脑显示出更多的双侧萎缩。仅限于海马旁回和海马的感兴趣区域分析显示，该组患者的双侧海马旁回和右侧海马体积进一步缩小。最后，MCI-V 中白质病变的数量与额叶和颞区以及丘脑和中脑的灰质体积呈负相关。结论：目前的研究结果为腔隙性梗塞患者 MCI 实体的解剖学基础提供了支持。灰质和白质的变化似乎都会导致此类患者的认知障碍。版权所有 (c) 2007 S. Karger AG，巴塞尔。
Background: The aim of the present study was to investigate whether there were differences in neuroradiological features, including white-matter lesions and gray-matter volumes, between patients with lacunar infarction with and without mild cognitive impairment of the vascular type (MCI-V). Methods: A total of 40 patients with lacunar infarction were studied within 1 month after stroke. Results: MCI-V was found in 22 patients, who in comparison with patients without cognitive impairment were significantly older and had fewer years of formal education. MRI subcortical hyper-intensities especially in the basal ganglia (putamen and thalamus) were significantly more frequent in the MCI-V group. In the voxel-based morphometric study, patients with MCI-V showed more atrophy bilaterally in the middle temporal gyrus, right and left frontal and posterior bilateral occipitoparietal regions including the posterior cingulate as well as in the cerebellum. A region of interest analysis restricted to the parahippocampi and hippocampi showed further reduced bilateral parahippocampal gyrus and right hippocampus volume reductions in this group of patients. Finally, the amount of white-matter lesions among MCI-V showed negative correlations with gray-matter volume in frontal and temporal areas as well as with the thalamus and mesencephalon. Conclusions: The present findings provide support for an anatomical substrate of the MCI entity in patients with lacunar infarction. Both gray- and white-matter changes seem to contribute to the cognitive impairment of such patients. Copyright (c) 2007 S. Karger AG, Basel.