脑白质疏松与认知障碍

摘要/Abstract

摘要：

脑白质疏松（leukoaraiosis，LA）是引起皮质下缺血的原因之一，国内外的研究结果关于LA在认知障碍中的作用仍存在争议，比如LA是否能引起认知障碍，LA所致认知功能损害的类型有哪些，LA的严重程度及损害部位与认知功能损害的关系等。本文就LA与认知障碍的关系做一综述。

文章导读： 【点睛】
本文综述了脑白质疏松与认知障碍的研究及目前存在的争议，并对研究方向提出设想。

关键词: 脑白质疏松; 认知障碍; 影像学

Abstract:

Leukoaraiosis(LA) is one of the reasons of the subcortical ischemia, the relationship between LA and cognitive impairment remains controversial at home and abroad, such as, whether LA can cause cognitive impairment or not, which type of cognitive impairment can it cause, what's the relationship between the severity and the location of LA and cognitive impairment, and so on. This paper reviews the relationship between LA and cognitive impairment.

Key words: Leukoaraiosis; Cognitive impairment; Imaging

石庆丽1，韩利坤2，黄恩雨3，袁春1，王春雪1，张玉梅1. 脑白质疏松与认知障碍[J]. 中国卒中杂志, 2013, 8(02): 138-141.

SHI Qing-Li*, HAN Li-Kun, HUANG En-Yu, YUAN Chun, WANG Chun-Xue, ZHANG Yu-Mei.. Leukoaraiosis and Cognitive Impairment[J]. Chinese Journal of Stroke, 2013, 8(02): 138-141.

参考文献

Hachinski VC, Potter P, Merskey H. Leukoaraiosis[J]. Arch Neurol, 1987, 44:21-26.

Wen W, Sachdev PS, Li JJ, et al. White matter hyperintensities in the forties:their prevalence and topography in an epidemiological sample aged 44-48[J]. Human Brain Mapping, 2009, 30:1155-1167.

Burns JM, Church JA, Johnson DK, et al. White matter lesions are prevalent but differentially related with cognition in aging and early Alzheimer disease[J]. Archives of Neurology, 2005, 62:1870-1876.

Price CC, Jefferson AL, Merino JG, et al. Subcortical vascular dementia:Integrating neuropsychological and neuroradiologic data[J]. Neurology, 2005, 65:376-382.

Lamar M, Dannhauser TM, Walker Z, et al. Memory complaints with and without memory impairment:the impact of lerkoaraiosis on cognition[J]. J Int Neuropsychol Soc, 2011, 17:1104-1112.

Ross ED, Hansel SL, Orbelo DM, et al. Relationship of leukoaraiosis to cognitive decline and cognitive aging[J]. Cogn Behav Neurol, 2005, 18:89-97.

Longstreth WT Jr, Arnold AM, Beauchamp NJ Jr, et al. Incidence-manifestations and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly:the cardiovascular health study[J]. Stroke, 2005, 36:56-61.

van Straaten EC, Fazekas F, Rostrup E, et al. Impact of white matter hyperintensities scoring method on correlations with clinical data:the LADIS study[J]. Stroke, 2005, 36:836-840.

卢林龙, 冯涛, 刘萍, 等. 急性缺血性卒中患者脑白质病变与认知功能障碍的相关性研究[J]. 中国卒中杂志, 2010, 5:882-887.

Adam MB, Karen LS, Jordan M, et al. White matter hyperintensities and cognition:Testing the reserve hypothes[J]. Neurobiol Aging, 2011, 32:1588-1598.

潘婕, 罗本燕. 小血管病性脑白质病变与认知功能障碍关系研究[J]. 中国卒中杂志, 2012, 7:762-768.

Mueller SG, Mack WJ, Mungas D, et al. Influences of lobar gray matter and white matter lesion load on cognition and mood[J]. Psychiatry Res, 2009, 181:90-96.

Brickman AM, Siedlecki KL, Muraskin J, et al. White matter hyperintensities and cognition:Testing the reserve hypothesis[J]. Neurobiol Aging, 2009, 28:177-184.

Jun-Young L, Philip I, Mackin RS, et al. Different associations of white matter lesions with depression and cognition[J]. BMC Neurology, 2012, 12:83.

Van Dijk EJ, Prins ND, Vrooman HA, et a1. Progression of cerebral small vessel disease in relation to risk factors and cognitive consequences:Rotterdam Scan study[J]. Stroke, 2008, 39:2712-2719.

Yuan JL, Wang SK, Peng P, et al. Characteristics of cognitive impairment in patients with leukoaraiosis[J]. Zhonghua Yi Xue Za Zhi, 2012, 92:147-151.

金香兰, 郑硕, 张允岭, 等. 脑白质疏松轻度认知障碍患者认知损害特点分析[J]. 中国卒中杂志, 20ll, 6:539-542.

Smith EE, Salat DH, Jeng J, et al. Correlations between MRI white matter lesion location and executive function and episodic memory[J]. Neurology, 2011, 76:1492-1499.

Nordahl CW, Ranganath C, Yonelinas AP, et al. White matter changes compromise prefrontal cortex function in healthy elderly individuals[J]. J Cogn Neurosci, 2006, 18:418-429.

Lamar M, Catani M, Price CC, et al. The impact of region-specific leukoaraiosis on working memory deficits in dementia[J]. Neuropsychologia, 2008, 46:2597-2601.

Wahlund LO, Barkhof F, Fazekas F, et al. A new rating scale for age-related white matter changes applicable to MRI and CT[J]. Stroke, 2001, 32:1318-1322.

Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging[J]. AJNR Am J Neuroradiol, 1987, 8:421-426.

Esiri MM, Nagy Z, Smith MZ, et al. Cerebrovascular disease and threshold for dementia in the early stages of Alzheimer's disease[J]. Lancet, 1999, 354:919-920.

Price CC, Mitchell SM, Brumback B, et al. MRI-leukoaraiosis thesholds and the phenotupic expression of dementia[J]. Neurology, 2012, 79:734-740.

Libon DJ, Price CC, Giovannetti T, et a1. Linking MRI hyperintensities with patterns of neuropsychological impairment[J]. Stroke, 2008, 39:806-813.

Greenwood PM. Functional plasticity in cognitive aging:review and hypothesis[J]. Neuropsychology, 2007, 21:657-673.

Domenico I, Giovanni P, Anna P, et al. Changes in white matter as determinant of global functional decline in older independent outpatients:three year follow up of LADIS(leukoaraiosis and disability) study cohort[J]. BMJ, 2009, 339:b2477.

Adam MB, Karen LS, Jordan M, et al. White matter hyperintensities and cognition:Testing the reserve hypothes[J]. Neurobiol Aging, 2011, 32:1588-1598.

Valdés Hernández Mdel C, Morris Z, Dickie DA, et al. Close correlation between quantitative and qualitative assessments of white matter lesions[J]. Neuroepidemiology, 2013, 40:13-22.

Nitkunan A, Charlton RA, Barrick TR, et a1. Redueed N-acetylaspartate is consistent with axoanl dysfunction in cerebral small vessel disease[J]. NMR Biomed, 2009, 22:285-291.

袁俊亮, 王双坤, 郭晓娟, 等. 脑白质疏松症患者认知功能障碍的磁共振波谱研究[J]. 中华医学杂志, 2012, 92:303-306.

Luan P, Lu BX, Pan SY. Correlation between diffusion anisotropy of the white matter fibers and cognitive function in patients with leukoaraiosis[J]. Nan Fang Yi Ke Da Xue Xue Bao, 2009, 29:1106-1110.

Jones DK, Lythgoe D, Horsfield MA, et al. Characterization of white matter damage in ischemic leukoaraiosis with diffusion tensor MRI[J]. Stroke, 1999, 30:393-397.

Simon WD, Nancy AD, Norbou GB, et al. Assessing the effects of age on long white matter tracts using diffusion tensor tractography[J]. Neuroimage, 2009, 46:530-541.

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