Subcortical lacunes are associated with executive dysfunction in cognitively normal elderly
Subcortical lacunes are associated with executive dysfunction in cognitively normal elderly
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DOI：
10.1161/strokeaha.107.491795
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发表时间：
2008-02-01
期刊：
影响因子：
8.3
通讯作者：
Chui, Helena C.
中科院分区：
文献类型：
--
作者：
Carey, Catherine L.;Kramer, Joel H.;Chui, Helena C.
背景和目的：正常老年人皮质下缺血性血管病（SIVD）和认知功能之间的关系尚不清楚，部分原因是研究方法的不一致。为了阐明这种关系，本研究在多变量模型中采用定量MRI和心理测量学上稳健的神经心理学测量方法，调查了一个特征良好的认知正常老年人样本（>= 55岁）。汇聚的证据表明，SIVD选择性损害额叶执行任务，扰乱额叶皮层下电路。因此，我们假设SIVD的MRI标记物将选择性地与较差的执行functions.Methods -我们研究了94名参与者谁是认知和功能正常。白色信号高强度（WMH），皮质下腔隙，海马体积和皮质灰质的体积测量，获得预测执行功能和情节memory. Results-Hierarchical回归复合措施的性能表明，在控制人口统计学变量，MMSE和颅内总体积后，皮质下腔隙的总数是唯一的显着预测因子，更多的缺陷与更差的执行业绩有关。海马体积最好的预测情景记忆performance.Conclusions -结果表明，SIVD的形式沉默的腔隙对应于较差的执行功能，即使在其他正常的老年人，这是一致的假设，SIVD优先破坏额叶皮层下电路。在这项研究中，33%的正常老年参与者患有腔隙性梗死，这一事实突出了这些发现的临床重要性。
Background and Purpose - The relationship between subcortical ischemic vascular disease (SIVD) and cognition in normal elderly is unclear, in part because of methodological inconsistencies across studies. To clarify this relationship, the current study investigated a well characterized cognitively normal elderly sample (>= 55 years) with quantitative MRI and psychometrically robust neuropsychological measures within a multivariate model. Converging evidence suggests that SIVD selectively impairs frontal-executive tasks by disrupting frontal-subcortical circuits. We therefore hypothesized that MRI markers of SIVD would be selectively associated with worse executive functioning.Methods - We studied 94 participants who were cognitively and functionally normal. Volumetric measures of white matter signal hyperintensity (WMH), subcortical lacunes, hippocampal volume, and cortical gray matter were obtained to predict performance on composite measures of executive functioning and episodic memory.Results - Hierarchical regression demonstrated that after controlling for demographic variables, MMSE, and total intracranial volume, the total number of subcortical lacunes was the only significant predictor, with a greater number of lacunes associated with poorer executive performance. Hippocampal volume best predicted episodic memory performance.Conclusions - Results suggest that SIVD in the form of silent lacunes corresponds to poorer executive functioning even in otherwise normal elderly, which is consistent with the hypothesis that SIVD preferentially disrupts frontal-subcortical circuits. The clinical importance of these findings is highlighted by the fact that 33% of the normal elderly participants in this study had lacunar infarcts.