Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns...Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitiv展开更多
目的探讨首发早发性抑郁症(EOD)患者脑灰质体积(GMV)异常及不同脑区的协同改变。方法对60例首发未用药EOD患者(病例组)与年龄、性别及受教育年限相匹配的64名健康对照者(对照组)行3.0 T 3D T1WI高分辨结构像扫描,采用基于体素形态学的...目的探讨首发早发性抑郁症(EOD)患者脑灰质体积(GMV)异常及不同脑区的协同改变。方法对60例首发未用药EOD患者(病例组)与年龄、性别及受教育年限相匹配的64名健康对照者(对照组)行3.0 T 3D T1WI高分辨结构像扫描,采用基于体素形态学的方法得到全脑GMV,采用独立样本t检验比较2组被试GMV是否存在差异,选取差异脑区作为种子点进行结构协变网络(SCN)分析,采用Spearman秩相关分析病例组差异脑区GMV与病程、汉密尔顿抑郁量表(HAMD)17评分的相关性。结果与对照组相比,病例组右侧眶额叶皮质、右侧背外侧前额叶、右侧顶下小叶、右侧顶上小叶、双侧楔前叶GMV升高(P<0.05,FDR校正)。以右侧眶额叶皮质、右侧背外侧前额叶作为种子点进行SCN分析发现病例组存在异常的协变脑区,主要位于额、顶、颞、枕叶皮层及边缘系统、小脑(P<0.05,FDR校正)。此外,病例组右侧眶额叶皮质(r=-0.314,P=0.015)、左侧楔前叶(r=-0.283,P=0.029)GMV与病程呈负相关,右侧背外侧前额叶GMV与HAMD17评分中焦虑/躯体化因子(r=0.331,P=0.010)、左侧楔前叶GMV与HAMD17评分中体质量因子(r=0.255,P=0.049)呈正相关。结论首发未用药EOD患者前额叶、顶叶部分脑区GMV存在异常改变,并且大脑中存在更广泛的协变脑区和结构连接。另外,部分脑区GMV异常改变与临床特征具有相关性。前额叶及顶叶部分脑区或许可成为客观评价抑郁症患者脑结构受损的生物学标记。展开更多
基金supported by the National Natural Science Foundation of China,No.81771237(to YXG)the National Key Basic Research Program of China(973 Program),No.2014CB541604(to YXG)+1 种基金the "Shu Guang" Project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation,China,No.16SG02(to LC)the Scientific Research Project of Huashan Hospital of Fudan University of China,No.2016QD082(to YL)
文摘Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitiv
文摘目的探讨首发早发性抑郁症(EOD)患者脑灰质体积(GMV)异常及不同脑区的协同改变。方法对60例首发未用药EOD患者(病例组)与年龄、性别及受教育年限相匹配的64名健康对照者(对照组)行3.0 T 3D T1WI高分辨结构像扫描,采用基于体素形态学的方法得到全脑GMV,采用独立样本t检验比较2组被试GMV是否存在差异,选取差异脑区作为种子点进行结构协变网络(SCN)分析,采用Spearman秩相关分析病例组差异脑区GMV与病程、汉密尔顿抑郁量表(HAMD)17评分的相关性。结果与对照组相比,病例组右侧眶额叶皮质、右侧背外侧前额叶、右侧顶下小叶、右侧顶上小叶、双侧楔前叶GMV升高(P<0.05,FDR校正)。以右侧眶额叶皮质、右侧背外侧前额叶作为种子点进行SCN分析发现病例组存在异常的协变脑区,主要位于额、顶、颞、枕叶皮层及边缘系统、小脑(P<0.05,FDR校正)。此外,病例组右侧眶额叶皮质(r=-0.314,P=0.015)、左侧楔前叶(r=-0.283,P=0.029)GMV与病程呈负相关,右侧背外侧前额叶GMV与HAMD17评分中焦虑/躯体化因子(r=0.331,P=0.010)、左侧楔前叶GMV与HAMD17评分中体质量因子(r=0.255,P=0.049)呈正相关。结论首发未用药EOD患者前额叶、顶叶部分脑区GMV存在异常改变,并且大脑中存在更广泛的协变脑区和结构连接。另外,部分脑区GMV异常改变与临床特征具有相关性。前额叶及顶叶部分脑区或许可成为客观评价抑郁症患者脑结构受损的生物学标记。
