Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS) study.
Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS) study.
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DOI：
10.1371/journal.pone.0061014
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Markus HS
中科院分区：
文献类型：
--
作者：
Lawrence AJ;Patel B;Morris RG;MacKinnon AD;Rich PM;Barrick TR;Markus HS
脑小血管病（SVD）是血管性认知功能障碍的常见原因。MRI可以评估许多疾病特征，包括腔隙性梗死、T2病变体积、脑萎缩和脑微出血。此外，扩散张量成像（DTI）对白色物质超微结构的破坏敏感，最近有人提出，可以从轴向扩散率（轴突损伤的建议标志物）和径向扩散率（脱髓鞘的指标）中获得关于损伤模式的额外信息。我们确定了这些全脑MRI标记物对SVD中认知障碍的贡献。腔隙性脑卒中合并融合性脑白质疏松患者被纳入正在进行的SVD认知障碍SCANS研究（n = 115），并接受神经心理学评估和多模式MRI。 SVD受试者在执行功能和处理速度测试中表现不佳。SVD组脑体积较低，白色高信号体积较高，所有弥散特征均与对照组（n = 50）有显著差异。 在多预测因子分析中，SVD患者执行功能的独立预测因子是腔隙性梗死计数和DTI显示的正常白色物质扩散率。处理速度的独立预测因子是腔隙性梗死计数和脑萎缩。径向弥散度是一个比轴向弥散度更强的DTI预测因子，这表明缺血性脱髓鞘，神经病理学上见于SVD，可能是SVD认知功能障碍的一个重要预测因子。我们的研究提供了SVD认知功能障碍的机制的信息。
Cerebral small vessel disease (SVD) is a common cause of vascular cognitive impairment. A number of disease features can be assessed on MRI including lacunar infarcts, T2 lesion volume, brain atrophy, and cerebral microbleeds. In addition, diffusion tensor imaging (DTI) is sensitive to disruption of white matter ultrastructure, and recently it has been suggested that additional information on the pattern of damage may be obtained from axial diffusivity, a proposed marker of axonal damage, and radial diffusivity, an indicator of demyelination. We determined the contribution of these whole brain MRI markers to cognitive impairment in SVD. Consecutive patients with lacunar stroke and confluent leukoaraiosis were recruited into the ongoing SCANS study of cognitive impairment in SVD (n = 115), and underwent neuropsychological assessment and multimodal MRI. SVD subjects displayed poor performance on tests of executive function and processing speed. In the SVD group brain volume was lower, white matter hyperintensity volume higher and all diffusion characteristics differed significantly from control subjects (n = 50). On multi-predictor analysis independent predictors of executive function in SVD were lacunar infarct count and diffusivity of normal appearing white matter on DTI. Independent predictors of processing speed were lacunar infarct count and brain atrophy. Radial diffusivity was a stronger DTI predictor than axial diffusivity, suggesting ischaemic demyelination, seen neuropathologically in SVD, may be an important predictor of cognitive impairment in SVD. Our study provides information on the mechanism of cognitive impairment in SVD.
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影响因子：
9.9
作者：
Charlton, R. A.;Morris, R. G.;Markus, H. S.
通讯作者：
Markus, H. S.
DOI：
10.1006/jmrb.1994.1037
发表时间：
1994-03-01
期刊：
JOURNAL OF MAGNETIC RESONANCE SERIES B
影响因子：
--
作者：
BASSER, PJ;MATTIELLO, J;LEBIHAN, D
通讯作者：
LEBIHAN, D
影响因子：
--
作者：
JUNQUE, C;PUJOL, J;MARTIVILALTA, JL
通讯作者：
MARTIVILALTA, JL
影响因子：
2.5
作者：
Grimaud, J;Lai, M;Miller, DH
通讯作者：
Miller, DH
影响因子：
3.5
作者：
Della Nave, R.;Foresti, S.;Mascalchi, M.
通讯作者：
Mascalchi, M.