LONGITUDINAL PET: LACUNES, COGNITION AND BEHAVIOR

纵向PET：空洞，认知和行为本项目使用纵向PET来解决关于这些患者的诊断，预后和认知功能障碍机制的重要问题。该基金采用纵向设计和完善的方法来解决尽管几十年的科学关注却收效甚微的问题。例如，目前很难确定脑血管病理和阿尔茨海默病在认知功能障碍和小皮质下中风（凹窝）患者中的相对作用。我们的初步数据表明PET可能有助于确定预后，我们将更明确地探讨PET的应用。这些临床的不确定性反映了对凹痕可能导致认知失败的机制的潜在困惑。发生在对认知功能至关重要的大脑结构中的凹痕（“战略性凹痕”）是IVD的主要原因，这一观点被广泛接受，但从未得到充分的验证。做是这个奖助金的主要目标。在我们的方案中增加纵向LET和MRI研究，提供了以独特的方式测试所有这些问题的机会，从而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125名受试者。将有75名腔隙性中风患者，伴有不同程度的认知功能障碍（正常、轻度认知障碍、痴呆）>研究对象采用正电子发射断层扫描（PET）测量脑区域代谢，MRI测量脑结构，神经心理测试和行为量表测量症状。所有受试者将接受年度临床随访评估，包括中期病史、神经系统检查、精神评估和神经心理测试。脑成像研究将在基线研究两年后重复进行。该项目有望更好地了解与皮质下脑卒中相关的认知功能障碍机制，改善临床诊断，并改善该人群认知功能过程的预测。

Longitudinal PET: Lacunes, Cognition and Behavior This project uses longitudinal PET to address important questions about diagnosis, prognosis, and the mechanisms of cognitive failure in these patients. The grant uses a longitudinal design and well established methods to address question that have yielded little progress despite decades of scientific attention. For example, it is presently extremely difficult to determine the relative contributions of cerebrovascular pathology and Alzheimer's disease in patients with cognitive dysfunction and small subcortical strokes (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 lacunes may cause cognitive failure. The belief that lacunes that occur in brain structures critical to cognitive function ("strategic lacunes") are the primary cause of IVD is widely accepted, yet it has never been adequately tested. To do is a major goal of this grant. The addition of longitudinal LET and MRI studies to out 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 125 subjects. There will be 75 subjects with lacunar strokes and different degrees of cognitive dysfunction (normal, mild cognitive impairment, dementia)> 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. All subjects will receive annual clinical follow-up evaluations consisting of interim medical history, neurological exams, psychiatric evaluations, and neuropsychological testing. Brain imaging studies will be repeated two 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.