成人烟雾病定量白质高信号的认知特征及缺血性预后。

IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Ziqi Liu, Xiaokuan Hao, Qi Duan, Chaoran Shen, Haojin Lyu, Junze Zhang, Jing Gu, Shihao He, Yanru Wang, Xilong Wang, Zhenyu Zhou, Ning Ma, Ran Duan, Xinlin Zhou, Xin Lou, Rong Wang
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引用次数: 0

摘要

背景:白质高强度(WMHs)与老年人群的长期卒中和认知能力下降有关,但与青年和中年人群不同,特别是对烟雾病(MMD)患者。本研究的目的是修改Fazekas分级,并定量分析wmh对成人烟雾病患者多个认知领域和2年临床缺血性事件的影响。方法:招募成年烟雾病患者和健康对照者进行综合认知评估。151例成人烟雾病患者的平均年龄为41.78±10.59岁,男女比例为0.94。校正定量全脑、心室周围(PVWMHs)和深部WMHs (DWMHs)被纳入比例风险模型,以探讨它们与2年缺血性事件的关系。采用线性回归分析评价不同脑区WMH负担与不同认知域的相关性。结果:烟雾病患者在智力(P = 0.000)、空间工作记忆(P = 0.011)、言语工作记忆1 (P = 0.000)、言语工作记忆2 (P = 0.000)、心理旋转(P = 0.008)、执行抑制(P = 0.011)方面均出现下降。定量全脑log10wmh(校正HR = 6.757, P = 0.001)和log10pvwmh(校正HR = 8.824, P = 0.000)与未来缺血性事件独立相关。定量PVWMH预测2年缺血性事件的曲线下面积(AUC)为0.701,优于Fazekas分级(AUC = 0.561) (P = 0.000)。结论:pvwmh对成人烟雾病患者的言语工作记忆、注意力和简单减法有更大的潜在影响。pvwmh的增加可能是成年烟雾病患者未来缺血性事件的一个指标。临床注册号:临床注册号:ChiCTR2200058251 URL: https://www.chictr.org.cn/。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive characteristics and ischemic prognosis of quantitative white matter hyperintensities in adult moyamoya disease.

Background: White matter hyperintensities (WMHs) are associated with long-term stroke and cognitive decline in the elderly population but differ from the young and middle-aged populations, especially for those with moyamoya disease (MMD). The aim of this study was to modify the Fazekas grade and quantitatively analyze the effects of WMHs on multiple cognitive domains and 2-year clinical ischemic events in adult MMD patients.

Methods: Adult MMD patients and healthy controls were recruited for a comprehensive cognitive assessment. Among 151 adult MMD patients, the average age was 41.78 ± 10.59 years and the male-to-female ratio was 0.94. Adjusted quantitative whole-brain, periventricular (PVWMHs), and deep WMHs (DWMHs) were included in the proportional hazards model to explore their relationships with 2-year ischemic events. Linear regression analysis was used to evaluate the correlation between the WMH burden in different brain regions and various cognitive domains.

Results: MMD patients present decreases in intelligence (P = 0.000), spatial working memory (P = 0.011), verbal working memory 1 (P = 0.000) and 2 (P = 0.000), mental rotation (P = 0.008), and executive inhibition (P = 0.011). Quantitative whole-brain log10WMHs (adjusted HR = 6.757, P = 0.001) and log10PVWMHs (adjusted HR = 8.824, P = 0.000) are independently associated with future ischemic events. The area under curve (AUC) of the quantitative PVWMH for the prediction of 2-year ischemic events is 0.701, which is better than that of the Fazekas grade (AUC = 0.561) (P = 0.000).

Conclusions: PVWMHs have greater potential effects on verbal working memory, attention, and simple subtraction in adult MMD patients when compared with DWMHs. An increase in PVWMHs could be an indicator of future ischemic events in adults with MMD.

Clinical registration: Clinical registration no. ChiCTR2200058251 URL: https://www.chictr.org.cn/ .

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