Progression of cerebral white matter lesions in Alzheimer's disease: a new window for therapy?
Progression of cerebral white matter lesions in Alzheimer's disease: a new window for therapy?
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DOI：
10.1136/jnnp.2004.053686
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发表时间：
2005-09-01
影响因子：
11
通讯作者：
Scheltens, P
中科院分区：
文献类型：
--
作者：
de Leeuw, FE;Barkhof, F;Scheltens, P
背景：白色病变（WML）是阿尔茨海默病的危险因素。WML的进展与血管因素和认知功能下降在人群为基础的研究，但WML的过程是未知的阿尔茨海默病。目的：调查的患病率和危险因素WML的进展阿尔茨海默病。对象：38例阿尔茨海默病患者的血压测量和连续脑MRI。方法：计算WML进展的患者比例，通过方差分析对基线不存在或存在WML进行分层。采用年龄和性别校正的logistic回归分析方法计算比值比（OR），以量化血压与WML进展的关系。基线时有WML的患者比基线时无WML的患者有显著更多的进展（校正平均差异= 1.2; 95%置信区间（CI），0.6 - 1.8）。舒张压（DBP）与WML进展特别相关（OR = 5.9（95%CI，1.0至37.6）每10 mm Hg DBP，p = 0.05）。结论：基线WML的阿尔茨海默病患者有WML快速进展的风险。WML可能提供一个潜在的治疗目标，在这种疾病，以改善认知能力下降的速度。
Background: White matter lesions (WML) are a risk factor for Alzheimers disease. Progression of WML is associated with vascular factors and cognitive decline in population based studies but the course of WML is unknown in Alzheimer's disease.Objective: To investigate the prevalence and risk-factors for progression of WML in Alzheimer's disease.Subjects: 38 patients with Alzheimer's disease for whom blood pressure measurements and sequential brain MRIs were available.Methods: The proportion of patients with progression of WML was calculated, stratified on baseline absence or presence of WML by analysis of variance. Odds ratios (OR) were calculated by age and sex adjusted logistic regression to quantify the relation between blood pressure and progression of WML.Results: About 25% of the patients showed progression of WML. Patients with WML at baseline had significantly more progression than those without WML at baseline (adjusted mean difference = 1.2; 95% confidence interval (CI), 0.6 to 1.8). Diastolic blood pressure (DBP) was particularly related to progression of WML (OR = 5.9 (95% CI, 1.0 to 37.6) per 10 mm Hg DBP, p = 0.05).Conclusions: Alzheimer's disease patients with WML at baseline are at risk for rapid progression of WML. WML may offer a potential treatment target in this disease to ameliorate the rate of cognitive decline.