High Degree of Dilated Virchow-Robin Spaces on MRI is Associated with Increased Risk of Dementia
High Degree of Dilated Virchow-Robin Spaces on MRI is Associated with Increased Risk of Dementia
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DOI：
10.3233/jad-2010-100378
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发表时间：
2010-01-01
影响因子：
4
通讯作者：
Tzourio, Christophe
中科院分区：
文献类型：
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作者：
Zhu, Yi-Cheng;Dufouil, Carole;Tzourio, Christophe
扩张的Virchow-Robin间隙（dVRS）的临床意义尚不清楚，其对认知表现的影响仅在小样本研究中报告。我们的目的是评估老年队列中dVRS的严重程度与痴呆和认知能力下降的风险之间的关系。在1,778名年龄在65至80岁之间的非痴呆受试者中，使用高分辨率3D MRI对白色物质和基底节的dVRS程度进行了排名，这些受试者在基线时进行了脑部MRI检查。在4年的随访期内，对认知功能进行了评估，并诊断为痴呆。考克斯比例风险模型被用来检查dVRS程度的4级严重程度评分和事件痴呆之间的关联。使用线性混合效应模型检查dVRS程度与认知变化之间的关系。在6,135人年的随访中，27人患上了痴呆症。最高程度的dVRS与痴呆事件风险的显著增加相关，独立于痴呆的其他标准风险因素，对于白色物质（HR = 9.8，95% CI 1.7-55.3）和基底节（HR = 5.8，95% CI 1.2-28.4）中的dVRS。在进一步调整白色高信号体积和脑梗死后，这种关联对于白色物质中的dVRS仍然是显著的。发现较高的认知能力下降率与基底节的dVRS程度有关，但与白色物质无关。这些结果需要确认，但它们表明，对dVRS严重程度的评估可能有助于识别痴呆风险增加的个体群体。
The clinical significance of dilated Virchow-Robin spaces (dVRS) remains unclear and their impact on cognitive performances has only been reported in small sample studies. Our aim was to assess the association between severity of dVRS and risk of incident dementia and cognitive decline in an elderly cohort. The degree of dVRS in both white matter and basal ganglia were ranked using high-resolution 3D MRI in a population-based sample of 1,778 non-demented participants from 65 to 80 years of age, who had a cerebral MRI at baseline. Cognitive function was assessed and dementia was diagnosed during a 4-year follow-up period. Cox proportional hazard models were used to examine the association between dVRS degree on a four-level severity score and incident dementia. The relationship between dVRS degree and change in cognition was examined using linear mixed effect models. During 6,135 person-years of follow-up, 27 individuals developed dementia. The highest degree of dVRS was associated with a strong increase in the risk of incident dementia independently of other standard risk factors of dementia, both for dVRS in white matter (HR = 9.8, 95% CI 1.7-55.3) and in basal ganglia (HR = 5.8, 95% CI 1.2-28.4). After further adjustment on white matter hyperintensity volume and brain infarcts, this association remained significant for dVRS in white matter. Higher rate of cognitive decline was found to be related to high degree of dVRS in basal ganglia but not in white matter. These results need confirmation but they suggest that assessment of the severity of dVRS may help identify groups of individuals that are at increased risk of dementia.