Voxel-Based Analysis of Diffusion Tensor Imaging in Patients with Subcortical Vascular Cognitive Impairment: Correlates with Cognitive and Motor Deficits
Voxel-Based Analysis of Diffusion Tensor Imaging in Patients with Subcortical Vascular Cognitive Impairment: Correlates with Cognitive and Motor Deficits
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DOI：
10.1111/j.1552-6569.2010.00527.x
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发表时间：
2011-10-01
影响因子：
2.4
通讯作者：
Na, Duk L.
中科院分区：
文献类型：
--
作者：
Kim, Sook Hui;Park, Jun Sung;Na, Duk L.
背景和目的小血管病变患者在T2加权磁共振(MR)图像上表现为高信号，代表缺血细胞损害。然而，尽管缺血性改变的程度相似，但临床表现的数量和严重程度可能会有所不同。我们使用基于体素的弥散张量成像(DTI)形态计量分析来研究缺血性改变的临床相关性。方法27例MCI和34例痴呆患者在磁共振成像(MRI)上均有明显的小血管病变。所有患者都接受了神经心理测试、锥体和锥体外量表(PEPS)对运动障碍的评分，以及包括DTI扫描在内的3-特斯拉磁共振成像。计算基于体素的分数各向异性和平均弥散系数图。结果根据每项认知测试，认知评分与幕上区域的DTI异常具有区域性特异性。出乎意料的是，大多数神经心理学测试中的认知缺陷，甚至在一些额叶任务中，都与后脑白质完整性的中断有关。运动障碍与幕上和幕下损害相关。结论研究结果提示，在表现为认知和运动障碍的小血管疾病患者中，纤维束损害的特定分布与临床缺陷的关系比整体缺血的严重程度更大。
BACKGROUND AND PURPOSEPatients with small vessel disease show high-signal intensity on T2-weighted magnetic resonance (MR) images that represent ischemic cell damage. However, despite a similar degree of ischemic change, the amount and the severity of clinical presentations may vary. We investigated the clinical correlations of ischemic changes using voxel-based morphometric analyses of diffusion tensor imaging (DTI).METHODSTwenty-seven MCI and 34 dementia patients were included who all had significant small vessel disease on magnetic resonance imaging (MRI). In all patients, neuropsychological tests, a rating on the Pyramidal and Extrapyramidal scale (PEPS) for motor deficits, and 3-Tesla MRI including DTI scans were performed. Voxel-based analysis of the fractional anisotropy and mean diffusivity maps were computed.RESULTSCognitive scores correlated with the DTI abnormalities in supratentorial areas with regional specificity according to each cognitive test. Unexpectedly, cognitive deficits in most neuropsychological tests, even in some frontal tasks, were associated with disruption of posterior white matter integrities. Motor deficits correlated with both supra-and infratentorial lesions.CONCLUSIONOur findings suggest that in patients with small vessel disease who show cognitive and motor impairments, a specific distribution of fiber tract damage is more related with clinical deficits than is the severity of the total ischemia.