不同严重程度认知障碍组脑内血管周围间隙研究  

Investigation of intracerebral enlarged perivascular space in cognitive impairment groups with different severity

作　　者：伏清扬 李跃华[1] 黄琳 郭起浩 FU Qingyang;LI Yuehua;HUANG Lin;GUO Qihao(Department of Radiology,the Sixed Hospital,Shanghai Jiaotong University,ShangHai 200233,China;Department of Geriatrics,the Sixed Hospital,Shanghai Jiaotong University,ShangHai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院放射科,上海200233 [2]上海交通大学附属第六人民医院老年科,上海200233

出　　处：《磁共振成像》2020年第4期241-245,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81871329);国家重点研发计划(编号:2016YFC1306305);上海市卫生计生委优秀学科带头人课题(编号:2017BR041)。

摘　　要：目的比较不同严重程度认知障碍组别脑内扩张血管周围间隙(enlarged perivascular spaces,EPVS)的差异,分析EPVS与认知功能的相关性。材料与方法纳入48例主观认知下降者(subjective cognitive decline,SCD),43例遗忘型轻度认知障碍者(amnestic mild cognitive impairment,a MCI),44例阿尔茨海默症(Alzheimer disease,AD)者以及43例认知功能正常(normal control,NC)的中老年人,行多项神经心理学测试及3.0 T多模态磁共振检查,在基底节区、半卵圆中心层面对EPVS计数并进行4级评分。用Kruskal-Wallis检验、Kolmogorov-Smirnov Z检验分析整体及组间差异,应用Spearman相关分析及偏相关分析与认知功能的相关性。结果AD组半卵圆中心评分(3.18±0.58)明显高于SCD组评分(2.60±0.64)(P<0.01)、aMCI组评分(2.77±0.81)(P<0.05)、NC组评分(2.56±0.77)(P<0.01)。控制年龄、性别、受教育年限后,偏相关分析结果显示,半卵圆中心EPVS与简明精神状态量表(mini-mental state examination,MMSE)及蒙特利尔认知评估基础量表(montreal cognitive assessment-basic,MoCA-B)评分显著负相关(r=-0.30、-0.37,P=0.000),与华山版听觉词语学习测验(auditory verbal learning test Huashan version,AVLT-H)延迟回忆及再认得分显著负相关(r=-0.241,P=0.002;r=-0.275,P=0.000),与波士顿命名测试(boston namingtest,BNT)评分显著负相关(r=-0.257,P=0.001)。基底节区EPVS与各项神经心理测试评分均无相关性。结论AD患者脑内半卵圆中心EPVS增多,半卵圆中心EPVS与整体认知功能、记忆、语言功能负相关。Objective:To investigate the intracerebral enlarged perivascular spaces(EPVS)in middle-aged and old people from community among cognitive impairment groups with different severity,and to analyze the relationship between EPVS and cognitive function.Materials and Methods:48 people with subjective cognitive decline(SCD),43 people with amnestic mild cognitive impairment(aMCI),44 people with Alzheimer’s disease(AD)and 43 normal controls(NC)were included in the study.Multiple neuropsychological tests and multimodal magnetic resonance imaging were conducted.EPVS in the basal ganglia and centrum semiovale were counted and graded from 0 to 4.Kruskal-Wallis test and KolmogorovSmirnov Z test were used to analyze the inter-group difference.Relationship between the scores of EPVS and cognitive function were analyzed using Spearman’s Correlation analyses and partial correlation.Results:EPVS was shown in all the examinees.EPVS score in AD group(3.18±0.58)was significantly higher than that in SCD group(2.60±0.64)(P<0.01),aMCI group(2.77±0.81)(P<0.05)and NC group(2.56±0.77)(P<0.01).PVS score were positively associated with age(P<0.05).After controlling age,gender and years of education,the partial correlation result showed that PVS scores in the centrum semiovale were negatively correlated with MMSE,MoCA-B(r=-0.30,-0.37,P=0.000),were negatively correlated with AVLT-N5,N7 scores(r=-0.241,P=0.002;r=-0.275,P=0.000),were significantly negatively associated with BNT scores(r=-0.257,P=0.001).However,no difference was found in EVPS in the basal ganglia.Conclusions:The EPVS in the centrum semiovale of AD group increases.EPVS in the centrum semiovale is negatively correlated with overall cognitive function,memory and language functions.

关 键 词：阿尔茨海默病 认知障碍 血管周围间隙 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学]