脑白质高信号与阿尔茨海默病认知障碍的相关性研究  

Correlations between white matter hyperintensities and cognitive impairment in Alzheimer's disease

作　　者：梁春华 颜学勤 黄耀辉 肖小华[1] Liang Chunhua;Yan Xueqin;Huang Yaohui;Xiao Xiaohua(Department of Geriatrics,Shenzhen Second People's Hospital,Guangdong 518035,China)

机构地区：[1]深圳市第二人民医院老年医学科,广东518035 [2]广东省生物医学信息检测与超声成像重点实验室深圳大学医学部生物医学工程学院,广东518035

出　　处：《脑与神经疾病杂志》2024年第9期541-546,共6页Journal of Brain and Nervous Diseases

基　　金：深圳市科技创新委员会可持续发展专项(KCXFZ20201221173213036);广东省生物医学信息检测与超声成像重点实验室开放课题资助(SZD202207)。

摘　　要：目的 采用定量化软件计算各部位脑白质高信号(WMH)体积,并分析其与认知功能的关系。方法选取2019年1月至2022年12月于深圳市第二人民医院住院的阿尔茨海默病(AD)患者65例、轻度认知障碍(MCI)患者67例、认知正常者(NC) 65例。所有参与者均已完善认知量表评估。通过ITK-SNAP软件分别标注并计算深部皮质下白质高信号(DWMH)、脑室旁白质高信号(PVWMH)和总脑白质高信号WMH体积,比较不同程度认知障碍患者间的各部位WMH体积的差异,通过Spearman偏相关性分析评估各WMH体积与认知评分及不同认知域之间的关系。结果 AD组、MCI组和NC组的DWMH、PVWMH和总WMH体积存在显著差异,AD组的各部位WMH体积最大,健康对照组的各部位WMH体积最小。两两组间比较还发现,在PVWMH和总WMH体积上,各组间比较差异均有统计学意义(P <0.05)。调整年龄、受教育年限、脑血管病、高血压及糖尿病等混杂因素后,各WMH体积与认知评分呈负相关,其中PVWMH及总WMH体积与认知评分的相关性更强。在单个认知域方面,DWMH、PVWMH和总WMH体积均与定向力、延迟回忆和注意力呈负相关,其中与定向力的相关性最强(r=-0.287、-0.305、-0.312),此外PVWMH和总WMH体积还与计算力障碍相关(r=-0.281、-0.254)。结论 各部位WMH体积与认知障碍密切相关,认知损害越重,WMH体积越大;与DWMH体积相比,PVWMH和总WMH体积与认知功能的相关性更强。DWMH、PVWMH和总WMH体积均与定向力、延迟回忆和注意力障碍密切相关。Objective We use quantitative techniques measure the volume of white matter hyperintensities in each part of the brain,and analyze the relationship between white matter hyperintensities(WMH)volume and cognitive function.Methods A total of 65 patients with Alzheimer's disease(AD),67 patients with mild cognitive impairment(MCI)and 65 patients with normal cognition(NC)were enrolled in Shenzhen Second People's Hospital from January 2019 to December 2022.All participants had completed the cognitive scale assessment.ITK-SNAP software was used to label and calculate Deep White Matter Hyperintensities(DWMH),Periventricular(WMH)(PVWMH),and(WMH).The differences in WMH volume were compared among patients with different degrees of cognitive impairment.Spearman partial correlation analysis was used to evaluate the relationship between WMH volume and cognitive score and different cognitive domains.Results There were significant differences in DWMH,PVWMH and total WMH volume in AD group,MCI group and NC group.The WMH volume in AD group was the largest,while the WMH volume in healthy control group was the smallest.The comparison between the two groups also found that there were significant differences in the volume of PVWMH and total WMH.After adjusting for confounding factors such as age,years of education,cerebrovascular disease,hypertension and diabetes,WMH volume was negatively correlated with cognitive score,among which PVWMH and total WMH volume were more strongly correlated with cognitive score(P<0.05).In terms of individual cognitive domains,DWMH,PVWMH and total WMH volume were negatively correlated with orientation,delayed recall and attention,and the correlation with orientation was strongest(r=-0.287,-0.305,-0.312).In addition,PVWMH and total WMH volume were also associated with dysnumeracy(r=-0.281,-0.254).Conclusion WMH volume was closely related to cognitive impairment,and the heavier the cognitive impairment,the greater the WMH volume;PVWMH and total WMH volume were more strongly associated with cognitive function

关 键 词：阿尔茨海默病 深部皮质下白质高信号 脑室旁白质高信号 认知障碍 

分 类 号：R743.32[医药卫生—神经病学与精神病学]