Progression of white matter hyperintensities in Alzheimer disease, dementia with Lewy bodies, and Parkinson disease dementia: a comparison with normal aging
Progression of white matter hyperintensities in Alzheimer disease, dementia with Lewy bodies, and Parkinson disease dementia: a comparison with normal aging
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DOI：
10.1097/01.jgp.0000236596.56982.1c
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发表时间：
2006-10-01
影响因子：
7.2
通讯作者：
O'Brien, John T.
中科院分区：
文献类型：
--
作者：
Burton, Emma J.;McKeith, Ian G.;O'Brien, John T.
目的：本研究的目的是调查横截面和纵向白色物质高信号（WMH）的变化，在老年人临床诊断为痴呆症。研究方法：在路易体痴呆（DLB）、帕金森病痴呆（PDD）、阿尔茨海默病（AD）受试者以及健康老年对照受试者中，间隔一年采集液体衰减反转恢复图像。使用自动化技术定量WMH体积。结果如下：与健康受试者（N=33，几何平均WMH：0.4%）相比，AD受试者（N= 23 [13%]，事后方差分析p < 0.001）的基线WMH（占脑体积的百分比）显著更大，但PDD受试者（N= 13 [0.6%]）或DLB受试者（N= 14 [0.4%]）则没有。WMH体积的增加（作为脑体积的百分比）没有显著差异（Kruskal-Wallis p = 0. 4)组间差异（AD中位数变化：0.08%; DLB：0.025%; PDD：0.07%，健康：0.02%）。基线WMH的严重程度，而不是痴呆的诊断或严重程度，是病变进展的重要预测因子。WMH的变化率与整体认知能力的变化无关。结论：显著的WMH进展发生在退行性痴呆中，其发生率受基线病变严重程度的影响，而不是痴呆类型或认知下降。
Objective: The objective of this study was to investigate cross-sectional and longitudinal white matter hyperintensity (WMH) changes in older subjects with clinically diagnosed dementia. Methods: Fluid-attenuated inversion recovery images were acquired one year apart in subjects with dementia with Lewy bodies (DLB), Parkinson disease dementia (PDD), Alzheimer disease (AD), and also healthy elderly comparison subjects. WMH volume was quantified using an automated technique. Results: Baseline WMH (as a percent of brain volume) was significantly greater compared with healthy subjects (N=33, geometric mean WMH: 0.4%) in subjects with AD (N= 23 [13%], analysis of variance post hoc p < 0.001) but not PDD(N= 13 [0.6%]) or DLB (N= 14 [0.4%]). Increase in WMH volume (as a percent of brain volume) was not significantly different (Kruskal-Wallis p = 0. 4) between groups (AD median change: 0.08%; DLB: 0.025%; PDD: 0.07%, healthy: 0.02%). Severity of baseline WMH, rather than diagnosis or severity of dementia, was a significant predictor of lesion progression. Rate of change of WMH bad no association with change in global cognitive performance. Conclusions: Significant WMH progression occurs in degenerative dementias with rates influenced by severity of lesions at baseline rather than dementia type or cognitive decline.