Cortical changes in cerebral small vessel diseases: a 3D MRI study of cortical morphology in CADASIL
Cortical changes in cerebral small vessel diseases: a 3D MRI study of cortical morphology in CADASIL
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DOI：
10.1093/brain/awn129
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发表时间：
2008-08-01
期刊：
影响因子：
14.5
通讯作者：
Chabriat, Hugues
中科院分区：
文献类型：
--
作者：
Jouvent, Eric;Mangin, Jean-Francois;Chabriat, Hugues
脑萎缩是脑血管疾病疾病进展的关键标志。脑小血管疾病（SVDB）过程中发生的皮层形态的3D变化仍然知之甚少。本研究的目的是评估一组常染色体显性遗传性脑小动脉病伴皮质下梗死和白质脑病（CADASIL）（一种遗传性SVDB）患者中影响皮质沟深度和表面积的变化及其临床和放射学相关性。数据来自69名CADASIL患者。使用经验证的方法来确定四个皮质沟的深度和表面积。脑与颅内腔体积的比值（脑实质分数BPF）、腔隙性病变（LL）和白色高信号体积、脑微出血数量和平均表观弥散系数也进行了测量。皮质沟的深度和表面积与BPF、临床状态和皮质下MRI病变之间的关系进行了测试。在54例患者中获得的皮质沟的深度和表面积与认知评分和残疾量表密切相关。深度与皮质下病变的程度有关，表面积仅与年龄有关。在其他分析中，扣带回沟深度与LL体积独立相关（P = 0.001），而上级额沟深度与平均表观扩散系数独立相关（P = 0.003）。在CADASIL中，皮质沟的重要形态学变化与临床恶化、皮质下组织损伤的扩展和全脑萎缩的进展相关。这些结果表明，检查皮质形态可能是高度的临床相关性SVDB。
Brain atrophy represents a key marker of disease progression in cerebrovascular disorders. The 3D changes of cortex morphology occurring during the course of small vessel diseases of the brain (SVDB) remain poorly understood. The objective of this study was to assess the changes affecting depth and surface area of cortical sulci and their clinical and radiological correlates in a cohort of patients with cerebral autosomal dominant arteriolopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a genetic SVDB. Data were obtained from a series of 69 CADASIL patients. Validated methods were used to determine depth and surface area of four cortical sulci. The ratio of brain to intracranial cavity volumes (brain parenchymal fractionBPF), volume of lacunar lesions (LL) and of white matter hyperintensities, number of cerebral microhaemorrhages, and mean apparent diffusion coefficient were also measured. Association between depth and surface area of the cortical sulci and BPF, clinical status and subcortical MRI lesions were tested. Depth and surface area of cortical sulci obtained in 54 patients were strongly correlated with both cognitive score and disability scales. Depth was related to the extent of subcortical lesions, surface area was related only to age. In additional analyses, the depth of the cingular sulcus was independently associated with the volume of LL (P = 0.001), and that of the superior frontal sulcus with the mean apparent diffusion coefficient (P = 0.003). In CADASIL, important morphological changes of cortical sulci occur in association with clinical worsening, extension of subcortical tissue damage and progression of global cerebral atrophy. These results suggest that the examination of cortical morphology may be of high clinical relevance in SVDB.