Total Cerebral Small Vessel Disease MRI Score Is Associated with Cognitive Decline in Executive Function in Patients with Hypertension.
Total Cerebral Small Vessel Disease MRI Score Is Associated with Cognitive Decline in Executive Function in Patients with Hypertension.
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DOI：
10.3389/fnagi.2016.00301
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发表时间：
2016
影响因子：
4.8
通讯作者：
Staals J
中科院分区：
文献类型：
--
作者：
Uiterwijk R;van Oostenbrugge RJ;Huijts M;De Leeuw PW;Kroon AA;Staals J
目的：高血压是脑白质高信号(WMH)、腔隙、脑微出血和血管周围间隙的主要危险因素，是脑小血管疾病(SVD)的MRI标志。研究表明，这些单独的MRI标志物与认知功能和衰退之间存在关联。最近，有人提出了一种“总SVD评分”，即将不同的MRI标志物合并为一个SVD测量指标，以反映SVD相关的全部脑损伤。我们调查了这种SVD评分是否与高血压患者4年来的认知功能下降有关。方法：在这项纵向队列研究中，130例高血压患者包括91例无并发症的高血压患者和39例高血压伴腔隙性卒中患者。他们在基线和4年后接受了神经心理学评估。在基线MRI上评估WMH、腔隙、脑微出血和血管周围间隙的存在。每个单独标志物的存在被添加以计算每个患者的SVD总分(范围0-4)。结果：未经校正的线性回归分析显示，奇异值分解得分与总体认知(p=0.017)、执行功能(p<；0.001)和信息处理速度(p=0.037)的下降有关，但与记忆力(p=0.911)无关。在调整了年龄、性别、教育程度、焦虑和抑郁评分、潜在的血管危险因素、患者组和基线认知表现后，SVD评分与总体认知和执行功能下降之间的相关性仍然显著。结论：我们的研究表明，SVD总分可以预测4年以上高血压患者的认知功能下降，特别是执行功能方面的下降。这强调了考虑由SVD引起的全部脑损伤的重要性。
Objectives: Hypertension is a major risk factor for white matter hyperintensities (WMH), lacunes, cerebral microbleeds, and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD). Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a “total SVD score” was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke) were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of WMH, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0–4) in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p = 0.017), executive functioning (p < 0.001) and information processing speed (p = 0.037), but not with memory (p = 0.911). The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group, and baseline cognitive performance. Conclusion: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.
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影响因子：
4
作者：
Pavlovic, Aleksandra M.;Pekmezovic, Tatjana;Sternic, Nada
通讯作者：
Sternic, Nada
影响因子：
4.8
作者：
Pantoni, Leonardo;Poggesi, Anna;Inzitari, Domenico
通讯作者：
Inzitari, Domenico
影响因子：
9.9
作者：
Jokinen, H.;Gouw, A. A.;Erkinjuntti, T.
通讯作者：
Erkinjuntti, T.
影响因子：
4.8
作者：
Huijts M;Duits A;van Oostenbrugge RJ;Kroon AA;de Leeuw PW;Staals J
通讯作者：
Staals J
DOI：
10.1111/ijs.12054
发表时间：
2015-04
期刊：
International journal of stroke : official journal of the International Stroke Society
影响因子：
--
作者：
Potter GM;Doubal FN;Jackson CA;Chappell FM;Sudlow CL;Dennis MS;Wardlaw JM
通讯作者：
Wardlaw JM