White matter lesions are prevalent but differentially related with cognition in aging and early Alzheimer disease
White matter lesions are prevalent but differentially related with cognition in aging and early Alzheimer disease
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DOI：
10.1001/archneur.62.12.1870
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发表时间：
2005-12-01
影响因子：
--
通讯作者：
Buckner, RL
中科院分区：
文献类型：
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作者：
Burns, JM;Church, JA;Buckner, RL
背景：白色病变（WML）在非痴呆老年人和阿尔茨海默病（AD）中普遍存在。目的：评估非痴呆老年和早期AD中WML与认知之间的关系。设计：横断面研究。设置：阿尔茨海默病研究中心，圣刘易斯，密苏里州。参与者：非痴呆（n=88）或患有非常轻度（n=48）或轻度（n=20）AD。主要结果测量：回归系数为深WMLs和脑室周围WMLs（PVWMLs）作为预测的认知，控制年龄，教育成就，脑萎缩，和infarct-like lesions.Results：白色物质病变存在于非痴呆性老龄化和早期AD，没有组间差异，在AD组的深WML负担和适度的PVWML负担增加。两组间梗死样病变的患病率相当。年龄和高血压与深部WML负荷和PVWML负荷有关。深度WML负担和PVWML负担与AD患者的整体认知能力降低相关，但与非痴呆老年人无关。一个PVWML X AD状态相互作用的整体认知表明，PVWML和认知之间的关系是由AD修改。在AD中，全球认知能力下降与视觉记忆，处理速度和执行功能障碍有关。结论：白色物质病变普遍存在于非痴呆性老龄化和早期AD中，它们的存在会影响AD早期阶段的认知障碍。早期AD患者可能比具有类似WML负担的非痴呆老年人更容易受到WML的认知影响。
Background: White matter lesions (WMLs) are prevalent in nondemented aging and in Alzheimer disease (AD). Their relationship with cognition in the earliest stages of AD is unknown.Objective: To assess the relationship between WMLs and cognition in nondemented aging and in early-stage AD.Design: Cross-sectional study.Setting: Alzheimer Disease Research Center, St Louis, Mo.Participants: Participants were nondemented (n=88) or had very mild (n=48) or mild (n=20) AD.Main Outcome Measures: Regression coefficients for deep WMLs and periventricular WMLs (PVWMLs) as predictors of cognition, after controlling for age, educational achievement, brain atrophy, and infarctlike lesions.Results: White matter lesions were present in nondemented aging and in early-stage AD, with no group differences in deep WML burden and a modest PVWML burden increase in the AD group. The prevalence of infarctlike lesions was equivalent between groups. Age and hypertension were related to deep WML burden and PVWML burden. Deep WML burden and PVWML burden were associated with reduced global cognition in AD but not in nondemented aging. A PVWML X AD status interaction for global cognition suggests that the relationship between PVWMLs and cognition is modified by AD. In AD, global cognitive reductions were related to impairments in visual memory, processing speed, and executive function.Conclusions: White matter lesions are prevalent in nondemented aging and in early-stage AD, and their presence influences cognitive impairment in the earliest stages of AD. Individuals with early-stage AD may be more vulnerable to the cognitive effect of WMLs than nondemented aging individuals with similar WML burden.