Association of White Matter Lesions and Lacunar Infarcts With Executive Functioning The SMART-MR Study
Association of White Matter Lesions and Lacunar Infarcts With Executive Functioning The SMART-MR Study
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DOI：
10.1093/aje/kwp256
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发表时间：
2009-11-01
影响因子：
5
通讯作者：
van der Graaf, Yolanda
中科院分区：
文献类型：
--
作者：
Geerlings, Mirjam I.;Appelman, Auke P. A.;van der Graaf, Yolanda
作者调查了白色病变和腔隙性梗死与认知能力的关系，以及脑萎缩是否介导了这些关系。在动脉疾病的第二种表现-磁共振研究（2001-2005，荷兰）中，对522例患者进行了横断面分析（平均年龄，57岁（标准差，10）; 76%为男性）。脑分割用于量化脑组织、脑脊液和白色病变的体积。目视评定样本。将脑体积、脑室体积和灰质体积除以颅内体积以获得脑萎缩的指标。进行神经心理学测试，评估执行功能和记忆，并将分数转换为z分数。作者使用线性回归分析，校正年龄、性别、教育、智力和血管危险因素，研究白色病变和腔隙性梗死数量与认知能力的关系。白色病变体积大于1个标准差（β =-0.12，95%可信区间：-0.20，-0.04）和存在≥ 2个腔隙性梗死（β =-0.48，95%可信区间：-0.87，-0.09）与执行功能较差相关。在调整脑萎缩后，这些关联仍然存在。两者都与记忆力下降无关。结果表明，皮质下缺血性血管病变与执行功能下降有关，但与记忆功能无关，与脑萎缩无关。
The authors investigated the association of white matter lesions and lacunar infarcts with cognitive performance and whether brain atrophy mediates these associations. Within the Second Manifestations of Arterial Disease-Magnetic Resonance study (2001-2005, the Netherlands), cross-sectional analyses of 522 patients were performed (mean age, 57 years (standard deviation, 10); 76% male). Brain segmentation was used to quantify volumes of brain tissue, cerebrospinal fluid, and white matter lesions. Infarcts were rated visually. Brain volume, ventricular volume, and gray matter volume were divided by intracranial volume to obtain indicators of brain atrophy. Neuropsychological tests assessing executive functioning and memory were performed, and scores were transformed into z scores. The authors used linear regression analyses, adjusted for age, sex, education, intelligence, and vascular risk factors, to investigate the association of white matter lesions and number of lacunar infarcts with cognitive performance. A 1-standard-deviation higher volume of white matter lesions (beta = -0.12, 95% confidence interval: -0.20, -0.04) and the presence of >= 2 lacunar infarcts (beta = -0.48, 95% confidence interval: -0.87, -0.09) were associated with worse executive functioning. These associations remained after adjusting for brain atrophy. Both were not associated with worse memory. Results suggest that subcortical ischemic vascular lesions are associated with decreased executive functioning, but not with memory functioning, independent of brain atrophy.