White matter lesions, quantitative magnetic resonance imaging, and dementia
White matter lesions, quantitative magnetic resonance imaging, and dementia
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DOI：
10.1097/00002093-200207000-00006
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发表时间：
2002-07-01
影响因子：
2.1
通讯作者：
Breitner, JCS
中科院分区：
文献类型：
--
作者：
Bigler, ED;Kerr, B;Breitner, JCS
作者对犹他州卡什县老年人群样本进行了定量和定性图像分析，将神经影像学结果与简易精神状态检查 (MMSE) 分数以及载脂蛋白 E epsilon4 等位基因的存在联系起来。神经影像学测量包括白、灰和海马体积；心室与大脑的比率（VBR）；以及脑室周围（PV）和半卵圆中心（CS）区域白质病变（WML）的定性评级。受试者包括 85 名可能患有阿尔茨海默病 (AD) 的人、21 名患有血管性痴呆 (VaD) 的人、30 名患有轻度/模糊性 (M/A) 认知症状的人、39 名非 AD 或 VaD 受试者但被诊断患有某种形式的神经精神疾病的异质组（“混合神经精神”组），以及 20 名年龄在 65 岁或以上的正常对照受试者。在控制年龄、性别和病程长度的情况下，作者发现 AD 和 VaD 受试者在 WML 上与对照受试者存在显着差异，但只有 VaD 受试者与 M/A 受试者存在显着差异。正如预期的那样，两个痴呆组还表现出明显的脑萎缩。 WML 通常随着年龄和痴呆的严重程度而增加。 PV WML 与白质体积损失和 MMSE 的更大损害显着但仅适度相关。大脑结构的定量测量与 MMSE 表现之间也存在适度的相关性。然而，当使用 VBR 测量控制脑萎缩程度时，WML 对 MMSE 表现的影响变得不显着，唯一显着的关系是海马体积和 MMSE 表现之间的关系。没有与 epsilon4 等位基因的存在和 MMSE 性能相关的显着定性或定量发现。讨论了 WML 在衰老和痴呆中的作用。
The authors performed quantitative and qualitative image analysis on a sample of the elderly population of Cache County, Utah, relating neuroimaging findings to Mini-Mental Status Examination (MMSE) scores and the presence of the apolipoprotein E epsilon4 allele. Neuroimaging measures included white, gray, and hippocampal volumes; a ventricle-to-brain ratio (VBR); and qualitative ratings of white matter lesions (WMLs) in the periventricular (PV) and centrum semiovale (CS) regions. Subjects included 85 persons with possible and probable Alzheimer disease (AD), 21 with vascular dementia (VaD), 30 with cognitive symptoms classified as mild/ambiguous (M/A), a heterogenous group of 39 non-AD or VaD subjects but diagnosed with some form of neuropsychiatric disorder ("Mixed Neuropsychiatric" Group), and 20 normal control subjects aged 65 years or older. Controlling for age, sex, and length of disease, the authors found that AD and VaD subjects differed significantly from control subjects on WMLs, but only the VaD subjects significantly differed from M/A subjects. The two dementia groups also displayed, as expected, significant cerebral atrophy. The WMLs generally increased with age and severity of dementia. PV WMLs were significantly but only modestly associated with white matter volume loss and greater impairment on the MMSE. Modest correlations were also present between the quantitative measures of cerebral structure and MMSE performance. However, when degree of cerebral atrophy was controlled by using the VBR measure, WML effects on MMSE performance became nonsignificant, with the only significant relationship remaining being that between hippocampal volume and MMSE performance. There were no significant qualitative or quantitative findings related to presence of the epsilon4 allele and MMSE performance. The role of WMLs in aging and dementia is discussed.