Presence of cerebral microbleeds is associated with cognitive decline in acromegaly.
Presence of cerebral microbleeds is associated with cognitive decline in acromegaly.
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DOI：
10.3389/fonc.2022.948971
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发表时间：
2022
影响因子：
4.7
通讯作者：
Liu, Jieping
中科院分区：
文献类型：
--
作者：
Xie, Zhengxing;Zhuang, Yan;Zhang, Zongqiang;Liu, Jieping
关键词：
肢端肥大症的认知功能减退越来越受到关注。脑微出血(CMBS)作为微血管损伤的放射学标志物，与各种类型的认知功能减退有关。然而，CMB的形成和肢端肥大症之间的联系还没有被量化。本研究旨在探讨以肢端肥大症为特征的生长激素(GH)分泌型垂体腺瘤CMBS的患病率、影像表现、认知功能与肢端肥大症相关性CMBS的关系。在55例生长激素分泌性垂体腺瘤(肢端肥大症)和70例健康对照(HC)患者的队列中，我们使用3.0-T磁共振扫描仪确定了CMBS的存在。通过磁化率加权成像(SWI)和微出血解剖学评分确定CMBS的数量、位置和分级。使用美国睡眠医学学会(AASM)评分手册2.2版的标准评估阻塞性睡眠呼吸暂停(OSA)。使用蒙特利尔认知评估(MoCA)评估入院后3天内的认知表现。探讨CMBS与认知功能及临床特征的关系。肢端肥大症CMBS发生率为29.1%，OSA发生率为65.5%。肢端肥大症患者和非肢端肥大症患者之间CMBS的患病率差异有统计学意义(分别为29.1%和5.3%)(P<0.01)。肢端肥大症合并CMBS患者的年龄明显低于HCS合并CMBS患者。与肥大症患者相比，肢端肥大症患者的认知功能显著下降，OSA的发生率也显著降低(P<0.01)。经年龄、教育程度和体重指数调整后的二元Logistic回归分析显示，CMB是肢端肥大症患者认知损害的独立危险因素(OR=3.19，95%CI1.51~6.76，P=0.002)。此外，在调整了年龄、体重指数、糖尿病和高血压的Logistic回归模型中，阻塞性睡眠呼吸暂停与肢端肥大症患者CMBS的发生独立相关(OR=13.34，95%CI3.09-57.51，P=0.001)。肢端肥大症患者的CMBS显著增加，这可能是OSA在肢端肥大症中的结果。目前的研究表明，肢端肥大症患者认知功能下降与CMBS增加有关。
Cognitive decline in acromegaly has gained increasing attention. Cerebral microbleeds (CMBs) as radiographic markers for microvascular injury have been linked to various types of cognitive decline. However, the association between CMB formation and acromegaly has not yet been quantified. This study is designed to investigate the prevalence and the radiographic patterns of CMBs and the association between cognitive function and acromegaly-related CMBs in growth hormone (GH)-secreting pituitary adenoma, which is characterized by acromegaly. In a cohort of 55 patients with GH-secreting pituitary adenoma (acromegaly) and 70 healthy control (HC) patients, we determined the presence of CMBs using a 3.0-T MRI scanner. The numbers, locations, and grades of CMBs were determined via susceptibility-weighted imaging (SWI) and the Microbleed Anatomical Rating Scale. Obstructive sleep apnea (OSA) was assessed using the criteria of the American Academy of Sleep Medicine (AASM) Scoring Manual Version 2.2. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive performance within 3 days of admission. The association between CMBs and cognitive function as well as clinical characteristics was explored. The incidence of CMBs was 29.1%, whereas that of OSA was 65.5% in acromegaly. There was a statistically significant difference in the prevalence of CMBs between subjects with and without acromegaly (29.1% and 5.3%, respectively) (p < 0.01). The age of acromegaly patients with CMBs was much younger compared with HCs with CMBs. Compared with HCs, a significant cognitive decline and the occurrence of OSA were demonstrated in patients with acromegaly (p < 0.01). Binary logistic regression analysis adjusted for age, education, and body mass index (BMI) revealed that CMB was an independent risk factor for cognitive impairment in patients with acromegaly (OR = 3.19, 95% CI 1.51–6.76, p = 0.002). Furthermore, in the logistic regression models adjusted for age, BMI, diabetes, and hypertension, OSA was independently associated with the occurrence of CMBs in patients with acromegaly (OR = 13.34, 95% CI 3.09–57.51, p = 0.001). A significant increase of CMBs was demonstrated in patients with acromegaly, which may be a result of OSA in acromegaly. The present study indicated that increasing CMBs are responsible for cognitive decline in patients with acromegaly.
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影响因子：
2.2
作者：
Celik D;Duyar SS;Aksu F;Firat S;Ciftci B
通讯作者：
Ciftci B
影响因子：
11
作者：
Pasi, Marco;Casolla, Barbara;Cordonnier, Charlotte
通讯作者：
Cordonnier, Charlotte
影响因子：
3.7
作者：
Wennberg, A.;Lorusso, R.;Maffei, P.
通讯作者：
Maffei, P.
DOI：
10.1016/j.jstrokecerebrovasdis.2020.105404
发表时间：
2021-09
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
Fisher M
通讯作者：
Fisher M
影响因子：
8.2
作者：
Giustina A;Barkhoudarian G;Beckers A;Ben-Shlomo A;Biermasz N;Biller B;Boguszewski C;Bolanowski M;Bollerslev J;Bonert V;Bronstein MD;Buchfelder M;Casanueva F;Chanson P;Clemmons D;Fleseriu M;Formenti AM;Freda P;Gadelha M;Geer E;Gurnell M;Heaney AP;Ho KKY;Ioachimescu AG;Lamberts S;Laws E;Losa M;Maffei P;Mamelak A;Mercado M;Molitch M;Mortini P;Pereira AM;Petersenn S;Post K;Puig-Domingo M;Salvatori R;Samson SL;Shimon I;Strasburger C;Swearingen B;Trainer P;Vance ML;Wass J;Wierman ME;Yuen KCJ;Zatelli MC;Melmed S
通讯作者：
Melmed S