LONGITUDINAL PET-LACUNES, COGNITION AND BEHAVIOR

纵向宠物缺陷、认知和行为

• 批准号: 7458882
• 负责人: Bruce Reed
• 金额: $ 32.64万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7458882
• 关键词: Address; Alzheimer' s Disease; Anisotropy; Atrophic; Attention; Autopsy; Behavior; Behavioral; Brain; Brain imaging; Cerebrovascular Disorders; Cerebrum; Clinical; Clinical Data; Cognition; Cognitive; Confusion; Data; Deterioration; Diagnosis; Disease; Etiology; Evaluation; Failure; Genus Capra; Goat; Grant; Hippocampus (Brain); Image; Impaired cognition; Impairment; Inferior; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Medical History; Memory; Metabolic; Metabolism; Methods; Neocortex; Neurologic; Neuropsychological Tests; Parietal Lobe; Pathology; Patients; Pattern; Persons; Population; Positron-Emission Tomography; Prefrontal Cortex; Protocols documentation; Relative (related person); Sampling; Score; Stroke; Structure; Study Subject; Symptoms; Testing; Thalamic structure; Time; Uncertainty; Vascular Dementia; Vascular Diseases; abstracting; brain metabolism; cerebrovascular; clinical Diagnosis; cognitive function; design; entorhinal cortex; executive function; follow-up; frontal lobe; improved; in vivo; longitudinal positron emission tomography; memory retention; mild neurocognitive impairment; outcome forecast; prospective; white matter

This project uses longitudinal PET to address important questions about diagnosis, prognosis, and the mechanisms of cognitive failure in patients with small vessel cerebrovascular disease. The grant uses a longitudinal design and well established methods to address questions that have yielded little progress despite decades of scientific attention. For example, it is presently extremely difficult to determine the relative contributions of ccrebrovascular pathology and Alzheimer's disease in patients with cognitive dysfunction and small subcortical strokes (iacunes). We will test whether or not certain PET findings can be used as in vivo markers for these different pathologies. Very little is known about how to predict cognitive decline in patients with lacunes. Our preliminary data suggest that PET may be useful in defining prognosis and we will explore this application of PET more definitively. These clinical uncertainties reflect underlying confusion about the mechanisms through which tacunes may cause cognitive failure. Damage to subcortical-frontal loops resulting in disconnection of the frontal lobes and attendant cognitive failure is one possible mechanism of ischemic vascular dementia. One goat of this gram is to test this hypothesis. The addition of longitudinal PET and MRI studies to our protocol offers the opportunity to test all of these questions in unique ways that allow stronger attributions of causality. This is a prospective, longitudinal study with an initial sample of 150 subjects. Approximately half of the subjects will have cerebrovascutar disease as revealed by MRI. About 1/3 will be cognitively normal, 1/3 will have mild cognitive impairment, and 1/3 will be demented. Subjects are studied with positron emission tomography (PET) to measure regional brain metabolism, with MRI to measure brain structures, and with neuropsychological tests and behavioral scales to measure symptoms. Difusion tensor imaging is added in this renewal as a potentially superior way of measuring white matter integrity. All subjects will receive annual clinical follow-up evaluations consisting of interim medical history, neurological exams, psychiatric evaluation, and neuropsychologicat testing. Brain imaging studies will be repeated two and four years after the baseline study. This project is expected to yield better understanding of the mechanisms of cognitive failure associated with subcortical stroke, to improve clinical diagnosis, and to improve the prediction of the course of cognitive function in this population.

本项目使用纵向PET来解决有关小血管脑血管病患者的诊断、预后和认知功能障碍机制的重要问题。该补助金使用纵向设计和完善的方法来解决尽管经过数十年的科学关注但进展甚微的问题。例如，目前极难确定脑血管病理学的相对贡献， 阿尔茨海默病患者认知功能障碍和小皮质下中风（iacunes）。我们将测试某些PET结果是否可以用作这些不同病理的体内标记物。关于如何预测腔隙患者的认知能力下降知之甚少。我们的初步数据表明，PET可能是有用的，在确定预后，我们将探讨这种应用PET更明确。这些临床不确定性反映了 关于tacunes可能导致认知障碍的机制的潜在困惑。皮层下-额叶环的损伤导致额叶的断开和伴随的认知障碍是缺血性血管性痴呆的一种可能机制。这只克的山羊是为了验证这个假设。在我们的方案中增加纵向PET和MRI研究，为以独特的方式测试所有这些问题提供了机会，这些方式允许更强的因果关系归因。这是一项前瞻性纵向研究，初始样本为150例受试者。大约一半的受试者将患有MRI显示的血管疾病。大约1/3将是认知正常的，1/3将有轻度认知障碍，1/3将痴呆。受试者通过正电子发射断层扫描（PET）来测量局部脑代谢，通过MRI来测量脑结构，并通过神经心理学测试和行为量表来测量症状。在本次更新中增加了弥散张量成像，作为测量白色物质完整性的潜在上级方法。所有受试者将接受年度临床随访评价，包括中期病史、神经系统检查、精神病学评价和神经心理学测试。在基线研究后2年和4年将重复进行脑成像研究。该项目有望更好地了解与皮质下卒中相关的认知功能障碍的机制，改善临床诊断，并改善对该人群认知功能过程的预测。