[1]黄梅,段炜,成戎川,等.孤立性侧脑室后角旁白质疏松对认知功能的影响及其神经心理特征[J].第三军医大学学报,2017,39(12):1262-1267.
 Huang Mei,Duan Wei,Cheng Rongchuan,et al.Neuropsychological characteristics of cognitive impairments associated with occipital periventricular leukoaraiosis[J].J Third Mil Med Univ,2017,39(12):1262-1267.
点击复制

孤立性侧脑室后角旁白质疏松对认知功能的影响及其神经心理特征(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第12期
页码:
1262-1267
栏目:
临床医学
出版日期:
2017-06-30

文章信息/Info

Title:
Neuropsychological characteristics of cognitive impairments associated with occipital periventricular leukoaraiosis
作者:
黄梅段炜成戎川郑健
第三军医大学新桥医院神经内科
Author(s):
Huang Mei Duan Wei Cheng Rongchuan Zheng Jian

Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China

关键词:
脑白质疏松症侧脑室后角旁认知损害
Keywords:
leukoaraiosis occipital periventricular cognitive impairment
分类号:
R338.64; R395.2; R742.02
文献标志码:
A
摘要:

目的        探讨孤立性侧脑室后角旁白质疏松对认知功能的影响及其神经心理特征。方法          纳入30例孤立性侧脑室后角旁白质疏松(后角组)、32例大脑半球多部位白质疏松(混合组)以及33例颅脑MRI证实无脑实质结构性改变的受试者(对照组),采用简易精神状态量表(mini-mental state examination scale, MMSE)和蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA,北京版),评价受试者总体认知功能,韦氏成人智力量表中数字广度测验分项目评估注意能力,临床记忆量表评估记忆能力,对比分析侧脑室后角旁白质疏松所致认知损害特征。结果       与对照组比较,后角组MMSE和MoCA总分较低(P<0.01),定向力、短时记忆、延迟记忆、指向记忆和语言测试单项评分也明显降低(P<0.05,P<0.01),而其他认知方面单项评分差异无统计学意义(P>0.05);混合组MMSE和MoCA总分较低(P<0.01),定向力、记忆力、注意能力、视觉空间与执行、语言测试和抽象认知单项评分也明显降低(P<0.05,P<0.01)。结论        孤立性侧脑室后角旁白质疏松导致以定向力、记忆力和语言能力减退为特征的认知功能损害。

Abstract:

Objective          To explore the effect of isolated occipital periventricular leukoaraiosis on cognitive function and the neuropsychological characteristics of the patients. Methods          Thirty patients with isolated occipital periventricular leukoaraiosis (occipital periventricular group), 32 patients with leukoaraiosis at multiple sites in the cerebral hemisphere (mixed group) and 33 subjects without structural changes in the brain parenchyma as confirmed by craniocerebral magnetic resonance (control group) were included in this study. The mini-mental state examination scale (MMSE) and the Montreal cognitive assessment (MoCA, Beijing) were used to evaluate the global cognitive function of the subjects. The digital span test (a subentry of the Wechsler adult intelligence scale) and the clinical memory scale were used to evaluate the attention and memory abilities of the subjects, respectively. The characteristics of cognitive impairment caused by occipital periventricular leukoaraiosis were analyzed in the patients. ResultsCompared with the control group, the patients with occipital periventricular leukoaraiosis had significantly lower average total scores of MMSE and MoCA (P<0.01) with also lower scores in the subentries including orientation, short-term memory, delayed memory directed memory and language tests (P<0.01, 0.05); the scores of the other subentries were comparable between the 2 groups (P>0.05). The patients in the mixed group had significantly lower average total scores of MMSE and MoCA (P<0.01) and lower scores for orientation, memory, attention, visual spatial and execution, and language abilities as well as for abstract cognition than the control group (P<0.01, 0.05). Conclusion        Isolated occipital periventricular leukoaraiosis causes cognitive impairments characterized by orientation, memory and language incompetence.

参考文献/References:

[1]Hachinski V C, Potter P, Merskey H. Leuko-araiosis[J]. Arch Neurol, 1987, 44(1): 21-23. DOI:10.1001/ archneur.1987. 00520130013009.
[2]de Leeuw F E, de Groot J C, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study[J]. J Neurol Neurosurg Psychiatr, 2001, 70(1): 9-14. DOI: 10.1136/jnnp.70.1.9.
[3]Breteler M M, van Swieten J C, Bots M L, et al. Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the rotterdam study[J]. Neurology, 1994, 44(7): 1246-1252. DOI: 10.1212/wnl.44.7.1246.
[4]彭超英, 解恒革, 李金梅. 脑白质疏松症相关因素的多因素回归分析[J]. 中国康复理论与实践, 2009, 15(7): 650-651. DOI:10.3969/j.issn.1006-9771.2009.07.020.
Peng C Y, Xie H G, Li J M. Related factors of leukoaraiosis: a multi-logistic regression analysis[J]. Chin J Rehab Theory Pract, 2009, 15(7): 650-651. DOI:10.3969/j.issn.1006-9771.2009.07.020.
[5]Maillard P, Carmichael O, Fletcher E, et al. Coevolution of white matter hyperintensities and cognition in the elderly[J]. Neurology, 2012, 79(5): 442-448. DOI:10.1212/ WNL.0b013e3182617136.
[6]Hajjar I, Quach L, Yang F, et al. Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: the Cardiovascular Health Study[J]. Circulation, 2011, 123(8): 858-865. DOI:10.1161/CIRCULATIONAHA.110.978114.
[7]Smith E E, Salat D H, Jeng J, et al. Correlations between MRI white matter lesion location and executive function and episodic memory[J]. Neurology, 2011, 76(17): 1492-1499. DOI:10.1212/wnl.0b013e318217e7c8.
[8]Kim K W, MacFall J R, Payne M E. Classification of white matter lesions on magnetic resonance imaging in elderly persons[J]. Biol Psychiatry, 2008, 64(4): 273-280. DOI:10.1016/j.biopsych.2008.03.024.
[9]Fazekas F, Chawluk J B, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging[J]. AJR Am J Roentgenol, 1987, 149(2): 351-356. DOI:10.2214/ajr.149.2.351.
[10]Defrancesco M, Marksteiner J, Deisenhammer E, et al. Impact of white matter lesions and cognitive deficits on conversion from mild cognitive impairment to Alzheimer’s disease[J]. J Alzheimers Dis, 2013, 34(3): 665-672. DOI: 10.3233/JAD-122095.
[11]Ai Q, Pu Y H, Sy C, et al. Impact of regional white matter lesions on cognitive function in subcortical vascular cognitive impairment[J]. Neurol Res, 2014, 36(5): 434-443. DOI:10.1179/1743132814Y.0000000354.
[12]Bolandzadeh N, Davis J C, Tam R, et al. The association between cognitive function and white matter lesion location in older adults: a systematic review[J]. BMC Neurol, 2012, 12: 126. DOI: 10.1186/1471-2377-12-126.
[13]郭起浩. 神经心理评估[M]. 第2版. 上海:上海科学技术出版社, 2016: 57-352.
Guo Q H. Neuropsychological assessment[M]. 2nd ed. Shanghai: Shanghai Science and Technology Press, 2016: 57-352.
[14]汤毓华, 张明园. 汉密顿抑郁量表(HAMD)[J]. 上海精神医学, 1984, 4(2): 61-64.
Tang Y H, Zhang M Y. Hamilton depression scale(HAMD)[J]. Shanghai Archives of Psychiatry, 1984, 4(2): 61-64.
[15]“临床记忆量表”编制协作组. “临床记忆量表”的编制[J]. 心理学报, 1986, 18(1): 100-108.
Collaborative group of the compilation of “Clinical memory scale”. the preparation of “Clinical memory scale”[J]. Acta Psychologica Sinica, 1986, 18(1): 100-108.
[16]Debette S, Markus H S. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and metaanalysis[J]. BMJ , 2010, 341(26): c3666-c3666. DOI:10.1136/bmj.c3666.
[17]Matthijs Biesbroek J, Kuijf H J, van der Graaf Y, et al. Association between subcortical vascular lesion location and cognition: a voxel-based and tractbased lesionsymptom mapping study. The SMARTMR Study[J]. PLoS One, 2013,8(4): e60541. DOI:10.1371/journal.pone.006054.
[18]Duan D, Shen L, Li C, et al. Memory impairment in occipital periventricular hyperintensity patients is associated with reduced functional responses in the insula and Heschl’s gyrus[J]. Int J Neurosci, 2016: 1-8. DOI:10.1080/00207454.2016.1198345.
[19]Duan D, Li C, Shen L, et al. Regional gray matter atrophy coexistent with occipital periventricular white matter hyper intensities[J]. Front Aging Neurosci, 2016, 8: 214. DOI: 10.3389/fnagi.2016.00214.
[20]Stenset V, Hofoss D, Berstad A E, et al. White matter lesion subtypes and cognitive deficits in patients with memory impairment[J]. Dement Geriatr Cogn Disord, 2008, 26(5): 424-431. DOI:10.1159/000165355.
[21]汤美慈.神经心理学[M]. 北京: 人民军医出版社, 2001: 67-68.
Tang M C, Neuropsychology[M]. Beijing: People’s Military Medical Publisher, 2001: 67-68.
[22]贾建平. 临床痴呆病学[M]. 北京: 北京大学医学出版社, 2007: 42-43.
Jia J P.Clinical dementia[M]. Beijing: Peking University Medical Press, 2007: 42-43.
[23]Schmidt R, Ropele S, Enzinger C, et al. White matter lesion progression, brain atrophy, and cognitive decline: the Austrian stroke prevention study[J]. Ann Neurol, 2005, 58(4): 610-616. DOI: 10.1002/ana.20630.
[24]Wen W, Sachdev P S, Chen X, et al. Gray matter reduction is correlated with white matter hyperintensity volume: a voxel-based morphometric study in a large epidemiological sample[J]. Neuroimage, 2006, 29(4): 1031-1039. DOI:10.1016/j.neuroimage.2005.08.057.

更新日期/Last Update: 2017-06-27