LONGITUDINAL PET: LACUNES, COGNITION AND BEHAVIOR

纵向正电子发射计算机断层扫描：缺陷、认知和行为这个项目使用纵向正电子发射计算机断层扫描来解决这些患者中有关诊断、预后和认知障碍机制的重要问题。这项拨款采用纵向设计和成熟的方法来解决这些问题，尽管几十年来科学关注的进展甚微。例如，目前很难确定认知功能障碍和皮质下小中风(腔隙)患者脑血管病理和阿尔茨海默病的相对贡献。我们的初步数据表明，PET可能有助于判断预后，我们将更明确地探索PET的这一应用。这些临床不确定性反映了对缺陷可能导致认知障碍的机制的潜在困惑。人们普遍认为，大脑结构中对认知功能至关重要的缺陷(“策略性缺陷”)是IVD的主要原因，但这一观点从未得到充分的检验。这样做是这笔赠款的一个主要目标。将纵向LET和MRI研究添加到OUT方案中，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。这是一项前瞻性的纵向研究，最初样本为125名受试者。将有75名患有腔隙中风和不同程度认知功能障碍(正常、轻度认知障碍、痴呆症)和GT的受试者；受试者接受正电子发射断层扫描(PET)测量大脑局部新陈代谢，MRI测量大脑结构，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，包括临时病史、神经学检查、精神病学评估和神经心理测试。脑成像研究将在基线研究后两年重复进行。这一项目有望更好地了解皮质下卒中相关认知障碍的机制，改善临床诊断，并改善对这一人群认知功能进程的预测。

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.