威利斯圈的形态变异与普通人群的认知障碍有关：J-SHIPP 研究。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-03-16 DOI:10.1016/j.jstrokecerebrovasdis.2025.108287

Yoko Okada MD, PhD , Yasuharu Tabara PhD , Katsuhiko Kohara MD, PhD , Satoko Takei MD , Masayuki Ochi MD, PhD , Michiya Igase MD, PhD , Yasumasa Ohyagi MD, PhD

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引用次数: 0

摘要

背景：不完全威利斯环（CoW）与缺血性脑卒中的严重程度和患者预后有关。然而，不完全CoW在健康成人中的临床意义尚不清楚。我们研究了居住在社区、表面健康的老年人不完全CoW与认知能力下降之间的关系。方法：对自愿参加爱媛大学医院抗衰老中心健康体检的829名50岁以上、功能独立的社区老年人（平均年龄：67.4±8.2岁）进行横断面研究。采用磁共振成像（mri）评定法泽卡分级法（Fazekas grading scale）中CoW的变化及脑血管病变程度。认知功能通过电脑问卷进行评估。结果：共有317名参与者完成了CoW。认知功能障碍常见于无CoW血管的受试者(完全CoW: 5.7%，无1支血管：9.0%，无≥2支血管：12.2%； = 0.023页)。在没有多血管的参与者中，皮层下和心室周围区域的2级或更高级别的白质病变是常见的。然而，不完全CoW与认知功能障碍之间的关联与白质病变和常规危险因素无关(缺1条血管：优势比 = 1.76,P = 0.09；≥2支血管缺失：优势比 = 2.21,P = 0.014)。结论：在一般人群中，2条或2条以上血管缺失与认知功能障碍独立相关，这表明CoW变异是认知功能下降的危险因素。经费：本工作得到日本文部科学省科学研究资助项目（20390185,21h04850,25293141）的支持。

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Morphologic variation of the circle of Willis is associated with cognitive impairment in a general population: the J-SHIPP study

Background

An incomplete circle of Willis (CoW) is associated with ischemic stroke severity and patient prognosis. However, the clinical significance of an incomplete CoW in healthy adults remains unclear. We examined the association between incomplete CoW and cognitive decline in community-dwelling, apparently healthy, older adults.

Methods

A cross sectional study in 829 community-dwelling, functionally independent ≥50 years older adults (mean age: 67.4 ± 8.2 years) who voluntarily participated in the health checkup program provided by the Anti-Aging Center of Ehime University Hospital. Variations in CoW and the degree of cerebral small vessel diseases by Fazekas grading scale were assessed using magnetic resonance imaging. Cognitive function was assessed using a computer-based questionnaire.

Results

A total of 317 participants had complete CoW. Cognitive impairment was frequently observed in participants with absent CoW vessels (complete CoW: 5.7%, absent 1 vessel: 9.0%, absent ≥2 vessels: 12.2%; P = 0.023). Grade 2 or higher white matter lesions in subcortical and periventricular regions were frequent in participants without multiple vessels. However, the association between incomplete CoW and cognitive impairment was independent of white matter lesions and conventional risk factors (absent 1 vessel: odds ratio = 1.76, P = 0.09; absent ≥2 vessels: odds ratio = 2.21, P = 0.014).

Conclusion

The absence of 2 or more vessels was independently associated with cognitive impairment in a general population, which suggests that CoW variation is a risk factor for cognitive decline.

Funding

This work was supported by a Grant-in-Aid for Scientific Research (20390185, 21H04850, 25293141) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.