Periventricular white matter hyperintensities increase the likelihood of progression from amnestic mild cognitive impairment to dementia.
Periventricular white matter hyperintensities increase the likelihood of progression from amnestic mild cognitive impairment to dementia.
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DOI：
10.1007/s00415-008-0874-y
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发表时间：
2008-09
影响因子：
6
通讯作者：
Alzheimer's Disease Cooperative Study Group
中科院分区：
文献类型：
--
作者：
van Straaten EC;Harvey D;Scheltens P;Barkhof F;Petersen RC;Thal LJ;Jack CR Jr;DeCarli C;Alzheimer's Disease Cooperative Study Group
白色高信号（WMH）对认知有影响，并且在患有遗忘型轻度认知障碍（aMCI）的个体中严重程度增加。WMH对aMCI进展为阿尔茨海默病（AD）的影响尚不清楚。数据来自一项为期三年的前瞻性、双盲、安慰剂对照临床试验，该试验检查了多奈哌齐或维生素E对从aMCI进展为AD的影响。使用标准化视觉评定量表，在进入试验时从152名研究参与者的子集获得的MR图像上对来自多个脑区的WMH进行评分。使用校正年龄、教育和治疗组的考克斯比例风险模型研究WMH对至进展时间的作用。152例aMCI受试者中有55例（36.2%）进展为AD。仅室周高信号（PVH）与3年内AD风险增加相关（HR = 1.59，95%CI = 1.24-2.05，p值< 0.001）。校正内侧颞叶萎缩或腔隙的存在没有改变统计学意义。PVH与aMCI进展为AD的风险增加相关。这表明PVH，一种被认为代表脑血管损伤的MRI发现，有助于独立于阿尔茨海默病病理学的脆弱个体的AD发作。
White matter hyperintensities (WMH) have an effect on cognition and are increased in severity among individuals with amnestic mild cognitive impairment (aMCI). The influence of WMH on progression of aMCI to Alzheimer’s disease (AD) is less clear. Data were drawn from a three-year prospective, double blind, placebo controlled clinical trial that examined the effect of donepezil or vitamin E on progression from aMCI to AD. WMH from multiple brain regions were scored on MR images obtained at entry into the trial from a subset of 152 study participants using a standardized visual rating scale. Cox proportional hazards models adjusting for age, education and treatment arm were used to investigate the role of WMH on time to progression. 55 of the 152 (36.2 %) aMCI subjects progressed to AD. Only periventricular hyperintensities (PVH) were related to an increased risk of AD within three years (HR = 1.59, 95 % CI = 1.24–2.05, p-value < 0.001). Correcting for medial temporal lobe atrophy or the presence of lacunes did not change statistical significance. PVH are associated with an increased risk of progression from aMCI to AD. This suggests that PVH, an MRI finding thought to represent cerebrovascular damage, contributes to AD onset in vulnerable individuals independent of Alzheimer pathology.
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影响因子：
3.1
作者：
Grundman, M;Lack, CR;Thal, LJ
通讯作者：
Thal, LJ
影响因子：
3.1
作者：
Grundman, M;Sencakova, D;Thal, LJ
通讯作者：
Thal, LJ
影响因子：
--
作者：
Lopez, OL;Jagust, WJ;Kuller, LH
通讯作者：
Kuller, LH
影响因子：
--
作者：
Burns, JM;Church, JA;Buckner, RL
通讯作者：
Buckner, RL
影响因子：
8.3
作者：
DeCarli, C;Fletcher, E;Jagust, WJ
通讯作者：
Jagust, WJ