Regional MRI Diffusion, White-Matter Hyperintensities, and Cognitive Function in Alzheimer's Disease and Vascular Dementia.
Regional MRI Diffusion, White-Matter Hyperintensities, and Cognitive Function in Alzheimer's Disease and Vascular Dementia.
复制标题
DOI：
10.3988/jcn.2016.12.2.201
复制
发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Vernieri F
中科院分区：
文献类型：
--
作者：
Altamura C;Scrascia F;Quattrocchi CC;Errante Y;Gangemi E;Curcio G;Ursini F;Silvestrini M;Maggio P;Beomonte Zobel B;Rossini PM;Pasqualetti P;Falsetti L;Vernieri F
最近有报道称，用核磁共振成像（MRI）测量认知障碍患者脑白质（NAWM）表现正常的脑水扩散率增加。然而，这是否反映了导致退行性或微血管病变的明显神经组织破坏仍有待澄清。通过比较阿尔茨海默病（AD）和血管性痴呆（VaD）患者NAWM的区域MRI表观扩散系数（adc）来解决这个问题。adc与白质高强度（WMH）负担、颈动脉粥样硬化和认知能力的关系也被研究。49例AD和31例VaD患者行脑MRI评估WMH体积和区域NAWM adc，神经心理学评估，颈动脉超声评估斑块严重程度和内膜-中膜厚度（IMT）。VaD和AD患者的NAWM区域adc无差异，但VaD患者的WMH体积大于AD患者。胼胝体前部ADC与WMH体积相关，颈动脉IMT增大与颞部ADC和WMH体积正相关。时间adc较高的患者的记忆表现更差。建构性实践得分与额叶、枕叶、胼胝体前后叶的adc以及WMH体积有关。抽象推理与额叶、顶叶和颞叶adc有关。我们的数据显示，NAWM中较高的区域adc与微循环损伤有关，如WMH体积所示。此外，NAWM的区域adc与记忆、建构性失用和抽象推理领域的神经心理表现存在不同的关联。
An increase in brain water diffusivity as measured using magnetic resonance imaging (MRI) has been recently reported in normal-appearing white matter (NAWM) in patients affected by cognitive impairment. However, it remains to be clarified if this reflects an overt neuronal tissue disruption that leads to degenerative or microvascular lesions. This question was addressed by comparing the regional MRI apparent diffusion coefficients (ADCs) of NAWM in patients affected by Alzheimer's disease (AD) or vascular dementia (VaD). The relationships of ADCs with the white-matter hyperintensity (WMH) burden, carotid atherosclerosis, and cognitive performance were also investigated. Forty-nine AD and 31 VaD patients underwent brain MRI to assess the WMH volume and regional NAWM ADCs, neuropsychological evaluations, and carotid ultrasound to assess the plaque severity and intima-media thickness (IMT). Regional ADCs in NAWM did not differ between VaD and AD patients, while the WMH volume was greater in VaD than in AD patients. The ADC in the anterior corpus callosum was related to the WMH volume, while a greater carotid IMT was positively correlated with the temporal ADC and WMH volume. The memory performance was worse in patients with higher temporal ADCs. Constructional praxis scores were related to ADCs in the frontal, and occipital lobes, in the anterior and posterior corpus callosum as well as to the WMH volume. Abstract reasoning was related to frontal, parietal, and temporal ADCs. Our data show that higher regional ADCs in NAWM are associated with microcirculatory impairment, as depicted by the WMH volume. Moreover, regional ADCs in NAWM are differently associated with the neuropsychological performances in memory, constructional praxia, and abstract reasoning domains.