脑白质疏松患者病变部位与认知功能的相关性

被引：30

作者：

冯丽 ^{[1
,2
]}

叶娜 ^{[2
]}

王金芳 ^{[2
]}

王诗男 ^{[2
]}

张玉梅 ^{[2
]}

机构：

[1] 承德, 承德市中心医院神经内科

[2] 北京, 首都医科大学附属天坛医院神经病学中心

来源：

中华行为医学与脑科学杂志 | 2018年 / 27卷 / 01期

关键词：

脑白质病变部位; 视觉分级量表; 认知障碍;

D O I：

暂无

中图分类号：

R742 [脑部疾病];

学科分类号：

100204 [神经病学];

摘要：

目的通过比较脑白质疏松(leukoaraisosis, LA)患者病变解剖位置与认知功能的关系, 探讨脑白质病变部位对认知功能的影响。方法选取75例LA患者, 由两名医师分别采用改良Scheltens量表、Manolio量表、Fazekas量表评估不同部位脑白质病变严重程度。采用蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评价认知障碍严重程度。采用Spearman等级相关分析评价脑白质病变部位与认知障碍的关系。应用t检验对脑室旁白质病变(Periventricular white matter lesions PWMLs)认知功能障碍组(PWMLs-CI)和认知功能正常组(PWMLs-CN)各个变量进行差异性检验。结果 Fazekas PWMLs与MoCA总分(r=-0.388, P=0.007)及视空间与执行(r=-0.466, P=0.000)、延迟回忆(r=-0.461, P=0.001)、抽象(r=-0.355, P=0.011)及定向力(r=-0.337, P=0.016)评分显著相关(P<0.05);Scheltens PWMLs与MoCA总分(r=-0.390, P=0.003)及视空间与执行(r=-0.464, P=0.000)、注意(r=-0.375, P=0.008)、延迟回忆(r=-0.484, P=0.000)及定向力(r=-0.342, P=0.013)评分呈负相关(P<0.05), 而皮层下白质病变(deep white matter lesions DWMLs)与MoCA总分无显著相关性(P>0.05)。与PWMLs-CN比较, PWMLs-CI在执行能力(42.13±0.89)、注意力(16.36±1.24)和视空间(2.25±0.31)评分降低, 差异有统计学意义(P<0.05)。结论脑白质病变部位对认知功能有影响, PWMLs更为密切, 其认知功能障碍特点表现为执行功能、注意力和视空间方面。

引用

共 17 条

[1]

Lesion location and cognitive impact of cerebral small vessel disease..[J].Biesbroek J Matthijs;Weaver Nick A;Biessels Geert Jan.Clinical science (London; England : 1979).2017, 8

[2]

Specific locations within the white matter and cortex are involved in the cognitive impairments associated with periventricular white matter lesions (PWMLs).[J].Xin Ding;Jialing Wu;Zhujuan Zhou;Jian Zheng.Behavioural Brain Research.2015,

[3]

The Role of the Cerebellum in Cognition.[J].Maryam Noroozian.Neurologic Clinics.2014, 4

[4]

Amnestic multiple cognitive domains impairment and periventricular white matter hyperintensities are independently predictive factors progression to dementia in mild cognitive impairment [J].

Lee, Hyun Kyung ;

Lee, Young Min ;

Park, Je Min ;

Lee, Byung Dae ;

Moon, Eun Soo ;

Chung, Young In .

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 2014, 29 (05) :526-532

[5]

The association between cognitive function and white matter lesion location in older adults: a systematic review [J].

Bolandzadeh, Niousha ;

Davis, Jennifer C. ;

Tam, Roger ;

Handy, Todd C. ;

Liu-Ambrose, Teresa .

BMC NEUROLOGY, 2012, 12

[6]

Processing speed and executive functions in cognitive aging: How to disentangle their mutual relationship? [J].

Albinet, Cedric T. ;

Boucard, Geoffroy ;

Bouquet, Cedric A. ;

Audiffren, Michel .

BRAIN AND COGNITION, 2012, 79 (01) :1-11

[7]

Volume of white matter hyperintensities in healthy adults: Contribution of age; vascular risk factors; and inflammation-related genetic variants.[J].Naftali Raz;Yiqin Yang;Cheryl L. Dahle;Susan Land.BBA - Molecular Basis of Disease.2011, 3

[8]

The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis..[J].Debette Stéphanie;Markus H S.BMJ (Clinical research ed.).2010, 7767

[9]

The relation between white-matter lesions and cognition [J].