不同脑小血管病影像学总负荷评分认知正常中老年人脑灰质体积的差异  

Differences of brain gray matter volume in middle-aged and elderly people with normal cognition and different total imaging burden scores of cerebral small vessel disease

作　　者：张晓倩[1] 刘思睿 范晓媛 侯波[1] 有慧[1] 朱以诚[2] 马超[3] 左真涛[4] 冯逢[1,5] ZHANG Xiaoqian;LIU Sirui;FAN Xiaoyuan;HOU Bo;YOU Hui;ZHU Yicheng;MA Chao;ZUO Zhentao;FENG Feng(Department of Radiology,Severe and Rare Diseases,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Neurology,Severe and Rare Diseases,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Human Anatomy,Histology and Embryology,Institute of Basic Medical Sciences CAMS,School of Basic Medicine PUMC,Beijing 100730,China;State Key Laboratory of Brain and Cognitive Science,Institute of Biophysics,Chinese Academy of Sciences,Beijing 100101,China;State Key Laboratory of Difficult,Severe and Rare Diseases,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院神经内科,北京100730 [3]中国医学科学院基础医学研究所北京协和医学院基础学院人体解剖与组胚学系,北京100730 [4]中国科学院生物物理研究所脑与认知科学国家重点实验室,北京100101 [5]中国医学科学院北京协和医学院北京协和医院疑难重症及罕见病国家重点实验室,北京100730

出　　处：《中国医学影像技术》2023年第1期12-16,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金面上项目(82071899);中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-025)。

摘　　要：目的观察不同脑小血管病(CSVD)影像学总负荷评分(简称总负荷评分)的认知功能正常中老年人脑灰质体积(GMV)的差异。方法回顾性分析214名认知功能正常[经受教育年限校正的蒙特利尔认知评估量表(MoCA)评分≥26分]且年龄>55岁中老年志愿者头部MRI所示CSVD总负荷评分相关标志物,进行总负荷评分,将0~2分判定为轻中度负荷组,3~4分为重度负荷组,比较组间脑区GMV的差异。结果214名志愿者CSVD总负荷评分结果为0分64名,1分77名,2分34名,3分24名,4分15名;轻中度负荷组175名,重度负荷组39名。相比轻中度负荷组,CSVD重度负荷组双侧梭状回、右侧颞上回、左侧额下回及左侧顶叶下外侧GMV缩小,双侧纹状体(尾状核、壳核及苍白球)GMV增大(Padj均<0.05)。结论认知功能正常的中老年人中,相比CSVD轻中度负荷者,重度负荷者部分脑区皮层GMV缩小,而双侧纹状体GMV增大。Objective To explore the differences of brain gray matter volume(GMV)in middle-aged and elderly people with normal cognition and different total imaging burden scores of cerebral small vessel disease(CSVD).Methods The CSVD total burden scores of 214 aged>55 years middle-aged and elderly volunteers with normal cognitive function(Montreal cognitive assessment scale[MoCA]score≥26 corrected for years of education)were evaluated according to associated imaging markers showed on head MRI,and the ones with total burden score of 0—2 were divided into mild to moderate burden group,while those with 3—4 scores were divided into severe burden group.Then brain GMV were compared between groups.Results Among 214 volunteers,the total CSVD burden score was 0 in 64 ones,1 in 77,2 in 34,3 in 24 and 4 in 15 ones.There were 175 ones in the mild to moderate burden group and 39 ones in the severe burden group.Compared with those in mild to moderate total burden group,subjects in severe burden group had reduced GMV in bilateral fusiform gyrus,right superior temporal gyrus,left inferior frontal gyrus and left inferior lateral parietal brain regions,but enlarged GMV in bilateral striatum(caudate nucleus,putamen,and pallidum)(all Padj<0.05).Conclusion Among middle-aged and elderly people with normal cognitive function,compared with those with mild to moderate CSVD burden,the ones with severe burden reduced GMV in some cortical brain regions and enlarged GMV in bilateral striatum.

关 键 词：脑血管疾病 灰质 认知 影像学总负荷评分 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]