主页 > 医学前沿 >
【Stroke】DWI表观扩散系数反应脑淀粉样血管病患
题目：脑淀粉样血管病患者脑部微组织结构变化与认知损害独立相关
Tissue Microstructural Changes Are Independently Associated With Cognitive
Impairment in Cerebral Amyloid Angiopathy
Anand Viswanathan, MD, PhD; Pratik Patel, MD; Rosanna Rahman, PhD; R. N.
Kaveer Nandigam, MD; Catherine Kinnecom, BS, MS; Luc Bracoud, BS; Jonathan
Rosand, MD, MSc; Hugues Chabriat, MD, PhD; Steven M. Greenberg, MD, PhD Eric
E. Smith, MD, MPH, FRCPC
From the Department of Neurology and Hemorrhagic Stroke Research Program
(A.V., P.P., R.R., R.N.K.N., C.K., J.R., S.M.G., E.E.S.), Massachusetts
General Hospital and Harvard Medical School, Boston, Mass; the Department of
Neurology (H.C.), CHU Lariboisière, Assistance Publique des Hôpitaux de
Paris, Paris, France; and Bio-Imaging Technologies SAS (L.B.), Lyon, France.
Correspondence to Anand Viswanathan, MD, PhD, Hemorrhagic Stroke Research
Program, Massachusetts General Hospital, Stroke Research Center, 175
Cambridge Street, Suite 300, Boston, MA 02114. E-mail
aviswanathan1@partners.org
Background and Purpose— Cerebral amyloid angiopathy (CAA) is a major cause
of lobar intracerebral hemorrhage and cognitive impairment and is associated
with white matter hyperintensities and cerebral microbleeds. MRI diffusion
tensor imaging detects microstructural tissue damage in advanced CAA even in
areas that appear normal on conventional MRI. We hypothesized that higher
global mean apparent diffusion coefficient (mean ADC), reflecting a higher
amount of chronic tissue disruption caused by CAA, would be independently
associated with CAA-related cognitive impairment.
Methods— Preintracerebral hemorrhage cognitive impairment was systematically
assessed using a standardized questionnaire (IQCODE) in 49 patients. Volume
of white matter hyperintensities, number of microbleeds, and mean ADC were
determined from MRIs obtained within 14.0±22.5 days of intracerebral
hemorrhage cognitive impairment. White matter hyperintensities and mean ADC
were measured in the hemisphere uninvolved by intracerebral hemorrhage to
avoid confounding.
Results— Preintracerebral hemorrhage cognitive impairment was identified in
10 of 49 subjects. Mean ADC was the only variable associated with
preintracerebral hemorrhage cognitive impairment and was elevated in those
with preintracerebral hemorrhage cognitive impairment compared with those
without (12.4x10–4 versus 11.7x10–4 mm2/s; P=0.03). Mean ADC positively
correlated with age but not white matter hyperintensities or number of
microbleeds. In logistic regression controlling for age and visible cerebral
atrophy, mean ADC was independently associated with preintracerebral
hemorrhage cognitive impairment (OR per 1x10–4 mm2/s increase=2.45, 95% CI
1.11 to 5.40, P=0.04).
Conclusions— Mean ADC is independently associated with preintracerebral
hemorrhage cognitive impairment in CAA. The lack of correlation with other
MRI markers of CAA suggests that mean ADC may be sensitive to distinct
aspects of CAA pathology and its tissue consequences. These results suggest
that global MRI diffusion changes are sensitive to clinically relevant
microstructural alterations and may be useful markers of CAA-related tissue
damage. [标签:content1][标签:content2]
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-03-27 11:48
医学,生命科学网