Diffusion tensor imaging of thalamus correlates with cognition in CADASIL without dementia
Diffusion tensor imaging of thalamus correlates with cognition in CADASIL without dementia
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DOI：
10.1212/01.wnl.0000113760.72706.d2
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发表时间：
2004-03-09
期刊：
影响因子：
9.9
通讯作者：
Markus, HS
中科院分区：
文献类型：
--
作者：
O'Sullivan, M;Singhal, S;Markus, HS
背景：执行功能障碍是大脑常染色体显性动脉病变伴皮层下梗死和白质脑病（CADASIL）的早期特征，并可能发展为皮层下痴呆。认知功能障碍的机制尚不完全清楚，与T2病变体积的相关性不强。弥散张量成像（DTI）可提供较好的白质束损伤指标。先前的DTI研究表明，CADASIL患者的白质、丘脑和壳核出现异常，并与迷你精神状态检查（MMSE）相关。目的：确定DTI异常是否可以在非痴呆性CADASIL患者中识别，以及这些异常是否与执行功能特别密切相关。方法：18名CADASIL受试者进行了DTI和认知评估，包括执行功能的几个方面的测试。同时对12名年龄匹配的对照组进行DTI检查。结果：白质病变、正常表现的白质和正常表现的灰质（丘脑、壳核和苍白球）的平均弥漫性增加。执行功能的综合评分与表现正常的灰质（r = - 0.73, p = 0.002）和白质（r - - 0.68, p = 0.004）的弥散性相关。灰质的相关性最强的是丘脑（r = - 0.66, p = 0.004）；在控制了年龄、性别和T2病变体积后，这一结果仍然存在。与MMSE相关性较弱，T2病变体积与执行功能评分无相关性（r = - 0.29, p = 0.27）。结论：在非痴呆的CADASIL患者中存在外观正常的白质和深灰质异常，这些DTI测量与执行功能的相关性特别强。
Background: Executive dysfunction is an early feature in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy ( CADASIL) and may progress to a subcortical dementia. The mechanism of cognitive impairment is incompletely understood, and correlations with T2 lesion volumes are not strong. Diffusion tensor imaging (DTI) may provide a better index of white matter tract damage. Previous DTI studies in CADASIL demonstrated abnormalities in normal-appearing white matter, thalamus, and putamen and correlations with the Mini-Mental State Examination (MMSE). Objectives: To determine whether DTI abnormalities could be identified in nondemented patients with CADASIL and whether these correlated particularly strongly with executive function. Methods: Eighteen CADASIL subjects underwent DTI and cognitive assessment, including tests of several aspects of executive function. DTI was also performed on 12 age-matched control subjects. Results: Mean diffusivity was increased in white matter lesions, normal-appearing white matter, and normal-appearing gray matter ( thalamus, putamen, and globus pallidus). A composite score of executive function correlated with diffusivity in both normal-appearing gray matter ( r = - 0.73, p = 0.002) and white matter ( r - - 0.68, p = 0.004). The strongest correlation for gray matter was for the thalamus ( r = - 0.66, p = 0.004); this remained after controlling for age, gender, and T2 lesion volumes. Correlations with MMSE were much weaker, and there was no correlation between T2 lesion volume and the executive function score ( r = - 0.29, p = 0.27). Conclusions: Abnormalities of normal-appearing white and deep gray matter are present in nondemented CADASIL patients, and these DTI measurements correlate particularly strongly with executive function.