中国康复理论与实践2018，Vol.24Issue(3)：313-318,6.DOI:10.3969/j.issn.1006-9771.2018.03.013
胆碱能通路损伤在脑白质病变后认知障碍中的作用
Impact of Cholinergic Pathway Damage on Cognitive Impairment Caused by Cerebral White Matter Lesions
摘要
Abstract
Objective To investigate the relationship between cholinergic pathway damage and the executive dysfunction of patients with different degrees of cognitive impairment caused by cerebral white matter lesions(WML). Methods From March,2016 to December,2017,115 patients were recruited,whose characteristics,such as age,gender, education,and history of hypertension,diabetes and stroke were recorded.According to the T2-weighted MRI,80 patients were defined as WML.WML patients were divided into cognitively normal(CN)group(n=41),vascular cognitive impairment of none dementia(VCIND)group(n=21)and vascular dementia(VaD)group(n=18)ac-cording to the result of Montreal Cognitive Assessment(MoCA)and Clinical Dementia Rating(CDR).Other 35 cases without WML and cognitive impairment were as control group.WML under MRI were evaluated with Cho-linergic Pathways Hyperintensities Scale(CHIPS).All the WML patients were assessed with Stroop Color-Word Test,Trail Making Test, Symbol Digital Modalities Test, and Verbal Fluence Test.The correlation between the scores of CHIPS and the executive tests were analysed. Results There was no significant difference in age, gender, level of education, and cardiovascular disease risk factors among four groups(P>0.05),but there were significant differences in scores of MoCA and CHIPS(F>25.781,P<0.001),while the score of MoCA was the least(P<0.01)and the scores of CHIPS were the most in VaD group (P<0.001).The CHIPS scores of left and bilateral hemisphere negatively correlated with all the scores of execu-tive tests(P<0.05),while that of the right hemisphere just correlated with the scores of some executive tests(P<0.05). Conclusion For cognitive impairment after WML,cholinergic pathway damage may relate with the executive function impairment,especially the damage in left cerebral hemisphere.关键词
脑白质病变/认知障碍/胆碱能通路/执行功能Key words
cerebral white matter lesion/cognitive impairment/cholinergic pathway/executive function分类
医药卫生引用本文复制引用
王诗男,贾伟丽,冯丽,陈红燕,石庆丽,李越秀,张玉梅..胆碱能通路损伤在脑白质病变后认知障碍中的作用[J].中国康复理论与实践,2018,24(3):313-318,6.基金项目
国家自然科学基金项目(No.81371201) （No.81371201）
首都医科大学基础与临床合作重点项目(No.16JL03) （No.16JL03）
北京市医院管理局临床医学发展专项经费项目(No.ZYLX201836)National Natural Science Foundation of China(No.81371201),Capital Medical University Basic and Clinical Medical Cooperation Project(Key)(No.16JL03)and Beijing Municipal Administration of Hospitals Special Funding for Clinical Medicine Development(No.ZYLX201836) （No.ZYLX201836）
