皮质下梗死后认知功能障碍与白质纤维束完整性的扩散张量成像研究

doi:10.3969/j.issn.1672-6731.2021.05.013

摘要/Abstract

摘要：

目的采用扩散张量成像（DTI）分析白质纤维束完整性和损伤程度，并探讨脑卒中后认知功能障碍的发生机制。方法选择2016年3月至2018年12月共37例皮质下梗死患者，采用蒙特利尔认知评价量表（MoCA）评价认知功能，同时通过DTI获取关键兴趣区白质纤维束部分各向异性（FA），Pearson相关分析和偏相关分析探讨白质纤维束FA值与MoCA评分的相关性，并采用多因素线性逐步回归分析验证二者的线性数量关系。结果相关分析显示，皮质下梗死后认知功能障碍患者MoCA评分与患侧内囊前肢、前后放射冠、钩束、上纵束和下额枕束，健侧扣带回及双侧外囊FA值呈正相关（均P < 0.05）；进一步行多因素线性逐步回归，患侧上纵束（P=0.042）和下额枕束（P=0.006）FA值与MoCA评分存在线性回归关系。结论患侧上纵束和下额枕束完整性损害可以作为皮质下梗死后认知功能障碍的影像学标记。

关键词: 卒中, 脑缺血, 大脑皮质, 认知障碍, 白质, 磁共振成像

Abstract:

Objective To study the relationship between white matter fiber integrity and cognitive impairment after subcortical infarction, and to explore the possible mechanism with diffusion tensor imaging (DTI). Methods Total of 37 subcortical infarction patients with cognitive impairment were recruitded from March 2016 to December 2018. Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function. DTI was performed to obtain the fractional anisotropy (FA) of white matter fiber in the whole brain. The correlation between FA values and MoCA scores was analyzed by Pearson correlation analysis and partial correlation analysis and then the multiple linear regression model was established. Results Correlation analysis showed that decreased FA values in the bilateral external capsule, cingulate gyrus, and superior longitudinal fasciculus (SLF), inferior fronto-occipital fasciculus (IFOF), fasciculus, anterior limb of internal capsule, anterior and superior corona radiata were significantly correlated with MoCA scores (P < 0.05, for all). Multiple linear regression analysis showed that MoCA scores affected the SLF (P=0.042) and IFOF (P=0.006). Conclusions Impaired white matter filber integrity of the ipsilesional SLF and IFOF can be imaging biomarkers for cognitive impairment after subcortical infarction.

Key words: Stroke, Brain ischemia, Cerebral cortex, Cognition disorders, White matter, Magnetic resonance imaging

凌晴, 辛晓瑜, 汤荟冬. 皮质下梗死后认知功能障碍与白质纤维束完整性的扩散张量成像研究[J]. 中国现代神经疾病杂志, 2021, 21(5): 406-410.

LING Qing, XIN Xiao-yu, TANG Hui-dong. DTI study of white matter fiber integrity and the association with cognitive impairment after subcortical infarction[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2021, 21(5): 406-410.

https://journal11.magtechjournal.com/cjcnn/CN/Y2021/V21/I5/406

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2 皮质下梗死后认知功能障碍与白质纤维束完整性的扩散张量成像研究

DTI study of white matter fiber integrity and the association with cognitive impairment after subcortical infarction

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2 皮质下梗死后认知功能障碍与白质纤维束完整性的扩散张量成像研究

DTI study of white matter fiber integrity and the association with cognitive impairment after subcortical infarction

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