目的探讨皮层下缺血性脑血管病(sIVD)患者弥散张量成像(DTI)皮层下灰白质微结构变化与整体认知功能和执行功能的独立相关性。方法 66例SIVD患者(其中认知障碍非痴呆组30例,认知功能正常组36例)行常规核磁共振成像(MRI)和DTI检查,采用简...目的探讨皮层下缺血性脑血管病(sIVD)患者弥散张量成像(DTI)皮层下灰白质微结构变化与整体认知功能和执行功能的独立相关性。方法 66例SIVD患者(其中认知障碍非痴呆组30例,认知功能正常组36例)行常规核磁共振成像(MRI)和DTI检查,采用简易精神状态量表(mini-mental state examination,MMSE)和画钟试验(cDT)分别评价其整体认知功能和执行功能。比较两组患者常规MRI上脑形态学指标及皮层下灰白质的DTI参数,分析与SIVD患者认知功能相关的影像学独立相关因素。结果与认知功能正常(NCI)组相比较,认知障碍非痴呆(VCIND)组侧脑室周围白质病变(PVLs)分级显著增加(P<0.01),半卵圆中心看似正常白质(NAWM)区和白质病变(WMLs)区、壳核及丘脑的表观弥散系数(ADC,值显著增加(P<0.01),侧脑室前角NAWM、尾状核、壳核及丘脑的部分各向异性(FA)值显著降低(P<0.05)。控制年龄和受教育程度后,PVLs、半卵圆中心NAWM区和WMLs区ADC值、壳核ADC值与MMSE呈显著负相关(P<0.01);壳核及侧脑室前角NAWM区FA值与MMSE呈显著正相关。脑腔梗数目、侧脑室后角NAWM区及尾状核头部ADC值与CDT呈显著负相关;侧脑室前角NAWM区和丘脑FA值与CDT呈显著正相关。多元逐步回归分析显示半卵圆中心NAWM和WMLs区ADC值与MMSE呈独立负相关;尾状核头ADC值和腔梗数目与CDT呈独立负相关。结论在非痴呆SIVD患者中,半卵圆中心白质结构的完整性是影响SIVD患者整体认知功能的主要因素,且独立于常规MRI上的脑结构改变;尾状核微结构的改变和腔梗的数目是影响SIVD患者执行功能主要因素。展开更多
Background Hypertension （HTN） is a very prevalent public health problem and as the population ages,cognitive impairment （CI） is also going to be a public health burden.However,the relationship between hypertension...Background Hypertension （HTN） is a very prevalent public health problem and as the population ages,cognitive impairment （CI） is also going to be a public health burden.However,the relationship between hypertension duration and cognitive function declination worldwide is still unknown.The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.Methods At baseline,1 386 HTN patients and 293 normotensive （NT） people were enrolled.The HTN patients were further divided into four subgroups （duration of HTN 〈6 years,6-10 years,11-20 years,and 〉20 years） according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-state-examination （MMSE） and clock-drawing-test （CDT） in comparison with the NT group.Results More HTN patients had CI （45.3%） than NT subjects （30.4%）,and increased with HTN duration （P〈0.000 1）.Compared with the scores of MMSE and CDT in the NT group,the declines were higher in the HTN patients （P 〈0.000 1）,and in the four HTN subgroups,both MMSE and CDT scores fall when the HTN duration increased （P 〈0.05）.Furthermore,in the HTN population without CI,the trend in alteration of CI was relatively mild but still existed （P 〈0.05）.Conclusion People with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration,both in amnesic and nonamnesic function.展开更多
文摘目的探讨皮层下缺血性脑血管病(sIVD)患者弥散张量成像(DTI)皮层下灰白质微结构变化与整体认知功能和执行功能的独立相关性。方法 66例SIVD患者(其中认知障碍非痴呆组30例,认知功能正常组36例)行常规核磁共振成像(MRI)和DTI检查,采用简易精神状态量表(mini-mental state examination,MMSE)和画钟试验(cDT)分别评价其整体认知功能和执行功能。比较两组患者常规MRI上脑形态学指标及皮层下灰白质的DTI参数,分析与SIVD患者认知功能相关的影像学独立相关因素。结果与认知功能正常(NCI)组相比较,认知障碍非痴呆(VCIND)组侧脑室周围白质病变(PVLs)分级显著增加(P<0.01),半卵圆中心看似正常白质(NAWM)区和白质病变(WMLs)区、壳核及丘脑的表观弥散系数(ADC,值显著增加(P<0.01),侧脑室前角NAWM、尾状核、壳核及丘脑的部分各向异性(FA)值显著降低(P<0.05)。控制年龄和受教育程度后,PVLs、半卵圆中心NAWM区和WMLs区ADC值、壳核ADC值与MMSE呈显著负相关(P<0.01);壳核及侧脑室前角NAWM区FA值与MMSE呈显著正相关。脑腔梗数目、侧脑室后角NAWM区及尾状核头部ADC值与CDT呈显著负相关;侧脑室前角NAWM区和丘脑FA值与CDT呈显著正相关。多元逐步回归分析显示半卵圆中心NAWM和WMLs区ADC值与MMSE呈独立负相关;尾状核头ADC值和腔梗数目与CDT呈独立负相关。结论在非痴呆SIVD患者中,半卵圆中心白质结构的完整性是影响SIVD患者整体认知功能的主要因素,且独立于常规MRI上的脑结构改变;尾状核微结构的改变和腔梗的数目是影响SIVD患者执行功能主要因素。
文摘Background Hypertension （HTN） is a very prevalent public health problem and as the population ages,cognitive impairment （CI） is also going to be a public health burden.However,the relationship between hypertension duration and cognitive function declination worldwide is still unknown.The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.Methods At baseline,1 386 HTN patients and 293 normotensive （NT） people were enrolled.The HTN patients were further divided into four subgroups （duration of HTN 〈6 years,6-10 years,11-20 years,and 〉20 years） according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-state-examination （MMSE） and clock-drawing-test （CDT） in comparison with the NT group.Results More HTN patients had CI （45.3%） than NT subjects （30.4%）,and increased with HTN duration （P〈0.000 1）.Compared with the scores of MMSE and CDT in the NT group,the declines were higher in the HTN patients （P 〈0.000 1）,and in the four HTN subgroups,both MMSE and CDT scores fall when the HTN duration increased （P 〈0.05）.Furthermore,in the HTN population without CI,the trend in alteration of CI was relatively mild but still existed （P 〈0.05）.Conclusion People with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration,both in amnesic and nonamnesic function.
