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【Stroke】无神经体征的脑部微出血可导致整体认
Brain Microbleeds and Global Cognitive Function in Adults Without Neurological Disorder
Yusuke Yakushiji MD*; Masanori Nishiyama MD; Satomi Yakushiji MD; Tatsumi Hirotsu MD; Akira Uchino MD; Junko Nakajima MD; Makoto Eriguchi MD; Yusuke Nanri MD; Megumi Hara MD; Etsuo Horikawa PhD; and Yasuo Kuroda MD
From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., K.Y.), Department of Radiology (A.U.), Department of Preventive Medicine (M.H.), and Center for Comprehensive Community Medicine (E.H.), Faculty of Medicine, Saga University, Saga, Japan; and Yuai-Kai Oda Hospital (M.N, S.Y., T.H., J.N.), Kashima, Saga, Japan.
* To whom correspondence should be addressed. E-mail: yakushij@cc.saga-u.ac.jp.
Background and Purpose—Increasing attention has been paid to associations between cognitive dysfunction and brain microbleeds (MBs). Because all previous studies have investigated patients with neurological disorders, we examined subjects without neurological disorder in order to clarify pathogenic relationships.
Methods—A total of 518 consecutive adults without neurological disorder who had undergone health-screening tests of the brain were studied prospectively. Gradient-echo T2*-weighted MRI using a 1.5-T system was used to detect MBs. The Mini-Mental State Examination (MMSE) was administered to determine cognitive functions. MMSE scores <27 or >1.5 SDs below the age-related mean were regarded as subnormal.
Results—MBs were found in 35 subjects (6.8%). MMSE score <27 was found in 25 subjects (4.8%), with MMSE score >1.5 SDs below the age-related mean in 34 subjects (6.6%). Univariate analysis showed presence and number of MBs, short duration of education, and severe white matter hyperintensities as significantly associated with subnormal scores. In logistic regression analysis, presence of MBs (odds ratio [OR], 5.44; 95% CI, 1.83 to 16.19) and number of MBs (OR, 1.32; 95% CI, 1.04 to 1.68) still displayed significant associations with MMSE score <27. Logistic regression analysis revealed a significant relationship between presence (OR, 3.93; 95% CI, 1.44 to 10.74) and number (OR, 1.26; 95% CI, 1.01 to 1.59) of MBs and MMSE score >1.5 SDs below the age-related mean. Among MMSE subscores, "attention and calculation" was significantly lower in MB-positive subjects (P=0.017).
Conclusions—MBs appear to be primarily associated with global cognitive dysfunction. Brain Microbleeds and Global Cognitive Function in Adults Without Neurological Disorder
无神经功能障碍的脑微出血可导致整体认知功能下降
Yusuke Yakushiji MD*; Masanori Nishiyama MD; Satomi Yakushiji MD; Tatsumi Hirotsu MD; Akira Uchino MD; Junko Nakajima MD; Makoto Eriguchi MD; Yusuke Nanri MD; Megumi Hara MD; Etsuo Horikawa PhD; and Yasuo Kuroda MD
From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., K.Y.), Department of Radiology (A.U.), Department of Preventive Medicine (M.H.), and Center for Comprehensive Community Medicine (E.H.), Faculty of Medicine, Saga University, Saga, Japan; and Yuai-Kai Oda Hospital (M.N, S.Y., T.H., J.N.), Kashima, Saga, Japan.
* To whom correspondence should be addressed. E-mail: yakushij@cc.saga-u.ac.jp.
Background and Purpose—Increasing attention has been paid to associations between cognitive dysfunction and brain microbleeds (MBs). Because all previous studies have investigated patients with neurological disorders, we examined subjects without neurological disorder in order to clarify pathogenic relationships.
背景和目的：认知功能障碍和脑微出血之间的相关性越来越被关注。之前的研究都集中在伴有神经功能障碍的患者身上，我们则通过观察不伴有神经功能障碍的患者去阐明认知功能障碍和脑微出血之间的关系。
Methods—A total of 518 consecutive adults without neurological disorder who had undergone health-screening tests of the brain were studied prospectively. Gradient-echo T2*-weighted MRI using a 1.5-T system was used to detect MBs. The Mini-Mental State Examination (MMSE) was administered to determine cognitive functions. MMSE scores <27 or >1.5 SDs below the age-related mean were regarded as subnormal.
方法：我们对518名进行大脑健康检查且没有神经功能障碍的成人进行前瞻性研究，利用1.5T系统MRIT2加权梯度回波检测脑微出血。利用简短精神状态检查量表测定受试者认知功能，分值<27，或>基于年龄相关均数的1.5个标准差时则认为认知功能低于正常。
Results—MBs were found in 35 subjects (6.8%). MMSE score <27 was found in 25 subjects (4.8%), with MMSE score >1.5 SDs below the age-related mean in 34 subjects (6.6%). Univariate analysis showed presence and number of MBs, short duration of education, and severe white matter hyperintensities as significantly associated with subnormal scores. In logistic regression analysis, presence of MBs (odds ratio [OR], 5.44; 95% CI, 1.83 to 16.19) and number of MBs (OR, 1.32; 95% CI, 1.04 to 1.68) still displayed significant associations with MMSE score <27. Logistic regression analysis revealed a significant relationship between presence (OR, 3.93; 95% CI, 1.44 to 10.74) and number (OR, 1.26; 95% CI, 1.01 to 1.59) of MBs and MMSE score >1.5 SDs below the age-related mean. Among MMSE subscores, "attention and calculation" was significantly lower in MB-positive subjects (P=0.017).
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作者:admin@医学,生命科学 2011-02-19 05:14
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