Brain atrophy accelerates cognitive decline in cerebral small vessel disease The LADIS study

被引：128

作者：

Jokinen, H. ^{[1
,2
,3
]}

Lipsanen, J. ^{[3
]}

Schmidt, R. ^{[4
,5
]}

Fazekas, F. ^{[4
,5
]}

Gouw, A. A. ^{[6
]}

van der Flier, W. M. ^{[6
]}

Barkhof, F. ^{[6
]}

Madureira, S. ^{[7
]}

Verdelho, A. ^{[7
]}

Ferro, J. M. ^{[7
]}

Wallin, A. ^{[8
]}

Pantoni, L. ^{[9
]}

Inzitari, D. ^{[9
]}

Erkinjuntti, T. ^{[1
,2
]}

机构：

[1] Univ Helsinki, Cent Hosp, Dept Neurol, Helsinki, Finland

[2] Univ Helsinki, Dept Neurol Sci, Helsinki, Finland

[3] Univ Helsinki, Inst Behav Sci, Helsinki, Finland

[4] Med Univ Graz, Dept Neurol, Graz, Austria

[5] Med Univ Graz, MRI Inst, Graz, Austria

[6] Vrije Univ Amsterdam Med Ctr, Dept Radiol & Neurol, Amsterdam, Netherlands

[7] Hosp Santa Maria, Ctr Estudos Egas Moniz, Serv Neurol, Lisbon, Portugal

[8] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Gothenburg, Sweden

[9] Univ Florence, Dept Neurol & Psychiat Sci, Florence, Italy

来源：

NEUROLOGY | 2012年 / 78卷 / 22期

关键词：

MEDIAL TEMPORAL-LOBE; WHITE-MATTER HYPERINTENSITIES; ISCHEMIC VASCULAR-DISEASE; VISUAL ASSESSMENT; FOLLOW-UP; IMPAIRMENT; DISABILITY; DEMENTIA; LEUKOARAIOSIS; HIPPOCAMPAL;

D O I：

10.1212/WNL.0b013e3182583070

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To examine the independent contributions and combined interactions of medial temporal lobe atrophy (MTA), cortical and subcortical atrophy, and white matter lesion (WML) volume in longitudinal cognitive performance. Methods: A total of 477 subjects with age-related WML were evaluated with brain MRI and annual neuropsychological examinations in 3-year follow-up. Baseline MRI determinants of cognitive decline were analyzed with linear mixed models controlling for multiple confounders. Results: MTA and subcortical atrophy predicted significantly steeper rate of decline in global cognitive measures as well as compound scores for psychomotor speed, executive functions, and memory after adjusting for age, gender, education, lacunes/infarcts, and WML volume. Cortical atrophy independently predicted decline in psychomotor speed. WML volume remained significantly associated with cognitive decline even after controlling for the atrophy scores. Moreover, significant synergistic interactions were found between WML and atrophy measures in overall cognitive performance across time and the rate of cognitive decline. Synergistic effects were also observed between baseline lacunar infarcts and all atrophy measures on change in psychomotor speed. The main results remained robust after exclusion of subjects with clinical stroke or incident dementia, and after additional adjustments for progression of WML and lacunes. Conclusions: Brain atrophy and WML are independently related to longitudinal cognitive decline in small vessel disease. MTA, subcortical, and cortical atrophy seem to potentiate the effect of WML and lacunes on cognitive decline. Neurology (R) 2012;78:1785-1792

引用

页码：1785 / 1792

页数：8

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