白质病变患者白质微观结构变化与执行功能损害的相关性

中华行为医学与脑科学杂志 Pub Date : 2020-03-20 DOI:10.3760/CMA.J.CN371468-20190924-00678

Yanling Ma, Hongyan Chen, Jinfang Wang, Na Ye, Shinan Wang, Li Feng, Yue-xiu Li, Qingli Shi, Weili Jia, Yumei Zhang

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They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). 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(2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA(r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test(r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA(r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test(r=-0.424--0.630, all P<0.003125 after emendation). \n \n \nConclusion \nThe executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function. \n \n \nKey words: \nWhite matter lesions; Cognitive impairment; Diffusion tensor imaging; White matter fiber","PeriodicalId":9940,"journal":{"name":"中华行为医学与脑科学杂志","volume":"29 1","pages":"239-244"},"PeriodicalIF":0.0000,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation of white matter microstructural changes with executive function impairment in patients with white matter lesions\",\"authors\":\"Yanling Ma, Hongyan Chen, Jinfang Wang, Na Ye, Shinan Wang, Li Feng, Yue-xiu Li, Qingli Shi, Weili Jia, Yumei Zhang\",\"doi\":\"10.3760/CMA.J.CN371468-20190924-00678\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo explore abnormal microstructural changes of white matter in patients with white matter lesions(WML) using diffusion tensor imaging(DTI), and to determine the association of such abnormalities of DTI parameters with executive function. \\n \\n \\nMethods \\nTotally 34 patients with WML were recruited from the department of Neurology, Beijing Tiantan Hospital, Capital Medical University from March 2012 to May 2019.All patients with WML were scored with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA), and assessed with Montreal cognitive assessment (MoCA) and clinical dementia rating(CDR). They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). 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(2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA(r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test(r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA(r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test(r=-0.424--0.630, all P<0.003125 after emendation). \\n \\n \\nConclusion \\nThe executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function. \\n \\n \\nKey words: \\nWhite matter lesions; Cognitive impairment; Diffusion tensor imaging; White matter fiber\",\"PeriodicalId\":9940,\"journal\":{\"name\":\"中华行为医学与脑科学杂志\",\"volume\":\"29 1\",\"pages\":\"239-244\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华行为医学与脑科学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.CN371468-20190924-00678\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华行为医学与脑科学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.CN371468-20190924-00678","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

目的应用弥散张量成像（DTI）技术探讨白质病变（WML）患者白质微观结构的异常变化，并探讨DTI参数异常与执行功能的关系。方法选取首都医科大学北京天坛医院神经内科2012年3月至2019年5月收治的34例WML患者，采用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HamMA）对其进行评分，并采用蒙特利尔认知评定（MoCA）和临床痴呆评定（CDR）对其评分。他们被分为WML认知正常组、WML血管性认知障碍非痴呆组和WML痴呆组。采用Stroop颜色和单词测试（SCWT）、线索制作测试-A（TMTA）、数字符号测试和语言流利性测试来评估执行功能。此外，选择没有WML病变的健康老年人作为对照组，在MRI检查后，所有受试者的大脑都用Siemens 3.0T MR进行DTI。数据收集并通过基于体素的分析（VBA）进行分析。研究了四组患者大脑感兴趣区（ROI）和其他区域DTI的各向异性和平均扩散系数，并分析了它们与WML患者执行功能评分的相关性。结果（1）在这些执行功能测试中，认知障碍患者（WML-VAD组、WML-VCIND组）与正常认知组（WML-CN组、NC组）之间存在显著差异，如SCWT（B）（65.54±6.24 vs 43.67±0.95，76.75±2.13 vs 43.67士0）。95，65.54±6.24 vs 43.66±1.81，76.75±2.13 vs 43.66士1.81），SCWT（C）（88.58±6.76 vs 61.63±1.31，96.37±1.47 vs 61.63士1.31，88.58±67.6 vs 66.31±8.19，96.37士1.47 vs 66.31士8.19），TMTA，TMTB（88.66±6.55 vs 80.34±0.61，96.70±1.72 vs 80.34士0.61，88.66±6.5 5 vs 83.10±5.91，96.7±1.72 vs.83。10±5.91）、数字符号测试（39.25±5.63 vs 47.00±2.55，31.27±3.93 vs 47.0±2.5，39.25±56.3 vs 48.86±4.34，31.27士3.93 vs 48.86%±4.34）和语言流利度测试（8.94±1.00 vs 11.71±0.47，6.64±0.81 vs 11.71士0.47，8.94±1.00vs 10.86±0.69，6.64士0.81 vs 10.86士0.69）得分（P<0.05）；在认知障碍患者中，WML-VAD组与WML-VCIND组在SCWT（B）、SCWT（C）、TMTA、TMTB、数字符号测试和语言流利性测试得分方面存在显著差异（P<0.05）；WML-CN患者与NC组在SCWT（C）、语言流利性测试得分上存在显著差异（P<0.05），胼胝体膝、上下纵束和额枕下束MD值与SCWT（B）、SCWT（C）和TMTA时间呈正相关（r=0.432～0.609），但与数字符号测试和语言流利性测试的得分呈负相关（r=-0.424--0.630，校正后均P＜0.003125）。结论WML痴呆患者的执行功能明显下降。白质微观结构的破坏越严重，功能执行的破坏就越严重。关键词：白质病变；认知障碍；扩散张量成像；白质纤维

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Correlation of white matter microstructural changes with executive function impairment in patients with white matter lesions

Objective To explore abnormal microstructural changes of white matter in patients with white matter lesions(WML) using diffusion tensor imaging(DTI), and to determine the association of such abnormalities of DTI parameters with executive function. Methods Totally 34 patients with WML were recruited from the department of Neurology, Beijing Tiantan Hospital, Capital Medical University from March 2012 to May 2019.All patients with WML were scored with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA), and assessed with Montreal cognitive assessment (MoCA) and clinical dementia rating(CDR). They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). The anisotropy and mean diffusion coefficient of DTI in the region of interest (ROI) and other regions in the brain were studied in the four groups, and their correlation with scores of executive function in WML patients was analyzed. Results (1)In these executive function test, there were significant differences between the patients with cognitive impairment (WML-VAD group, WML-VCIND group) and normal cognition group(WML-CN group, NC group), such as SCWT(B)(65.54±6.24 vs 43.67±0.95, 76.75±2.13 vs 43.67±0. 95, 65.54±6.24 vs 43.66±1.81, 76.75±2.13 vs 43.66±1.81), SCWT(C)(88.58±6.76 vs 61.63±1.31, 96.37±1.47 vs 61 63±1.31, 88.58±6.76 vs 66.31±8.19, 96.37±1.47 vs 66.31±8.19), TMTA(40.47±2.76 vs 30.92±0.47, 44.24±1.43 vs 30.92±0.47, 44.24±1.43 vs 31.99±2.07, 40.47±2.76 vs 31.99±2.07), TMTB(88.66±6.55 vs 80.34±0.61, 96.70±1.72 vs 80.34±0.61, 88.66±6.55 vs 83.10±5.91, 96.70±1.72 vs 83. 10±5.91), Digit Symbol Test(39.25±5.63 vs 47.00±2.55, 31.27±3.93 vs 47.00±2.5, 39.25±5.63 vs 48.86±4.34, 31.27±3.93 vs 48.86±4.34) and Verbal Fluency Test(8.94±1.00 vs 11.71±0.47, 6.64±0.81 vs 11.71±0.47, 8.94±1.00 vs 10.86±0.69, 6.64±0.81 vs 10.86±0.69) scores (P<0.05); In the patients with cognitive impairment, there were significant differences between WML-VAD group and WML-VCIND group, such as SCWT(B), SCWT(C), TMTA, TMTB, digit symbol test and verbal fluency test scores (P<0.05); There were significant differences between WML-CN patients and NC group in the scores of SCWT (C), verbal fluency test(P<0.05). (2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA(r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test(r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA(r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test(r=-0.424--0.630, all P<0.003125 after emendation). Conclusion The executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function. Key words: White matter lesions; Cognitive impairment; Diffusion tensor imaging; White matter fiber

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中华行为医学与脑科学杂志

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期刊介绍： "Chinese Journal of Behavioral Medicine and Brain Science" (CN 37-1468/R, ISSN 1674-6554) is a national academic journal under the supervision of the National Health Commission, sponsored by the Chinese Medical Association and Jining Medical College. The journal was founded in June 1992 and was formerly known as "Chinese Journal of Behavioral Medicine" (1992-1993) and "Chinese Behavioral Medical Science" (1994-2008). In 2009, it was renamed "Chinese Journal of Behavioral Medicine and Brain Science" with the approval of the State Administration of Press, Publication, Radio, Film and Television. The purpose of "Chinese Journal of Behavioral Medicine and Brain Science" is to implement the health and health policies of the Party and the State, implement the principle of combining theory with practice and popularization and improvement, and reflect the major progress in the theory and practical application of behavioral medicine and brain science in my country. It publishes academic papers and scientific research results in the field of behavioral medicine and brain science in my country, and has columns such as monographs/reviews, basic research, clinical research, health prevention, methods and techniques, psychological behavior and evaluation, and systematic evaluation.