Accumulation of MRI Markers of Cerebral Small Vessel Disease is Associated with Decreased Cognitive Function. A Study in First-Ever Lacunar Stroke and Hypertensive Patients.
Accumulation of MRI Markers of Cerebral Small Vessel Disease is Associated with Decreased Cognitive Function. A Study in First-Ever Lacunar Stroke and Hypertensive Patients.
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DOI：
10.3389/fnagi.2013.00072
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发表时间：
2013
影响因子：
4.8
通讯作者：
Staals J
中科院分区：
文献类型：
--
作者：
Huijts M;Duits A;van Oostenbrugge RJ;Kroon AA;de Leeuw PW;Staals J
背景资料：白色病变（WML）、无症状腔隙性梗死、脑微出血（BMB）和血管周围间隙扩大（EPVS）已被确定为脑小血管病（cSVD）引起的无症状病变。所有这些标记都与认知功能有关，但彼此之间也有很强的相关性。这些标志物对认知功能的综合作用从未被研究过，可能会提供更多关于对认知功能影响的有用信息。研究方法：对189例有cSVD风险的患者（112例高血压患者和77例首次腔隙性卒中患者）进行了脑MRI和广泛的神经心理学评估。我们对基底节区是否存在任何无症状腔隙性梗死、广泛WML、任何深部BMB和中度至广泛EPVS进行了评级。将每种标志物的存在加和为0至4之间的顺序评分。与认知功能领域（记忆，执行功能，信息处理速度和整体认知）的关联进行了相关分析。结果如下：相关性分析显示，累积cSVD负担与所有认知领域的表现下降之间存在显著相关性（所有p ≤ 0.001）。在校正年龄和性别后，信息处理速度（r =-0.181，p = 0.013）和整体认知（r =-0.178，p = 0.017）的结果仍然显著。使用线性回归分析的趋势测试显示了相同的结果。讨论内容：我们测试了一种新的方法来捕获cSVD导致的总脑损伤，发现cSVD的MRI负担的积累与信息处理速度和整体认知测试的表现下降有关，这意味着累积的脑损伤伴随着更差的认知功能。
Background: White matter lesions (WMLs), asymptomatic lacunar infarcts, brain microbleeds (BMBs), and enlarged perivascular spaces (EPVS) have been identified as silent lesions due to cerebral small vessel disease (cSVD). All these markers have been individually linked to cognitive functioning, but are also strongly correlated with each other. The combined effect of these markers on cognitive function has never been studied and would possibly provide more useful information on the effect on cognitive function. Methods: Brain MRI and extensive neuropsychological assessment were performed in 189 patients at risk for cSVD (112 hypertensive patients and 77 first-ever lacunar stroke patients). We rated the presence of any asymptomatic lacunar infarct, extensive WMLs, any deep BMB, and moderate to extensive EPVS in the basal ganglia. The presence of each marker was summed to an ordinal score between 0 and 4. Associations with domains of cognitive function (memory, executive function, information processing speed, and overall cognition) were analyzed with correlation analyses. Results: Correlation analyses revealed significant associations between accumulating cSVD burden and decreased performance on all cognitive domains (all p ≤ 0.001). Results remained significant for information processing speed (r = −0.181, p = 0.013) and overall cognition (r = −0.178, p = 0.017), after correction for age and sex. Testing of trend using linear regression analyses revealed the same results. Discussion: We tested a new approach to capture total brain damage resulting from cSVD and found that accumulation of MRI burden of cSVD is associated with decreased performance on tests of information processing speed and overall cognition, implying that accumulating brain damage is accompanied by worse cognitive functioning.