磁共振上脑白质改变体积与认知功能和执行功能障碍的关系
首发时间:2011-01-21
摘要:目的:脑白质改变(white matter changes, WMC)与认知功能和执行功能之间的关系仍存在争议,本研究旨在探讨MRI上WMC的体积与认知功能和执行功能之间的相关性。 方法:收集存在血管性危险因素但无中风病史的患者,并评价患者的认知功能、执行功能,进行有关的实验室检查和磁共振扫描。患者的认知功能和执行功能分别应用临床常用且操作简便的简易智能量表(Mini Mental State Examination, MMSE)和Frontal Assessment Battery (FAB)来评价。磁共振上WMC的体积采用计算机辅助的自动分割方法进行测量。MMSE、FAB评分和WMC体积分别由两位不同的神经科医生完成。应用Spearman相关分析MMSE、FAB分值和WMC体积之间的关系。p≤ 0.05为有统计学意义。 结果:共收集50例患者,50例患者的平均年龄为61.2±9.3岁,受教育程度平均为4.86± 3.82年。在27例患者发现有WMC,有WMC的患者平均年龄高于无WMC的患者,女性比率,高血压比率和吸烟的比率高于无WMC的患者。在27例患者中,Spearman相关分析显示MMSE分值和WMC体积呈负相关(r=-0.399, p=0.011),FAB分值与WMC体积亦呈负相关(r=-0.265, p=0.048)。 结论:Spearman相关分析显示MMSE分值和FAB分值与WMC体积呈负相关,提示MMSE、FAB与WMC有量化关系。但是由于本研究病例数仍偏少,进一步的研究需扩大样本量以深入了解WMC体积与认知功能和执行功能之间的相关性。
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Cognitive impairment and executive dysfunction in patients with white matter changes: a quantitative MRI analysis
Abstract:Backgrounds: The existence of a quantitative relationship of dementia and executive dysfunction to cerebral white matter changes (WMC) remains controversial. Methods: Fifty patients with vascular risk factors without history of stroke were assessed. Clinical evaluations included cognitive assessment, laboratory investigations and MRI examination. We measured the volume of WMC with a computer-aided automated segmentation method for quantitative assessment of WMC. Cognitive impairment and executive dysfunction were assessed with Mini Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) respectively. Results: The mean age of patients was 61.2±9.3. The mean education was 4.86± 3.82 years. WMC were present in 27 patients. There were no differences in MMSE and FAB among patients with or without WMC. (25.38 vs 26.58, p=0.220; 11.69 vs 12.63, p=0.264 respectively). The Spearman correlation analysis showed that MMSE and the volume of WMC were correlated (r=-0.399, p=0.011). FAB also correlated to the volume of WMC (r=-0.265, p=0.048). Conclusions: Our data indicate that both MMSE and FAB are quantitatively correlated with the volume of WMC. Further study is needed to confirm the relationship between MMSE, FAB and the volume of WMC.
Keywords: White matter changes MMSE FAB MRI
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