国际神经病学神经外科学杂志2025，Vol.52Issue(6)：42-47,6.DOI:10.16636/j.cnki.jinn.1673-2642.2025.06.006
脑白质高信号与阿尔茨海默病患者认知障碍程度及认知内容的相关性分析
Association of white matter hyperintensities with the severity and content of cognitive impairment in patients with Alzheimer disease
摘要
Abstract
Objective To investigate the association of white matter hyperintensities(WMH)with the severity and specific cognitive domains of cognitive impairment in patients with Alzheimer disease(AD).Methods A total of 168 AD patients who were diagnosed and treated in Qinhuangdao Integrated Traditional Chinese and Western Medicine Hospital from January 2022 to December 2024 were enrolled as AD group,and 168 healthy individuals during the same period of time were enrolled as control group.Head magnetic resonance imaging(MRI)data and Mini-Mental State Examination(MMSE)score were collected from all subjects,and WMH was compared between the two groups.Cognitive function was compared between AD patients with different Clinical Research Center for Dementia of South Korea(CREDOS)scores,and a Spearman rank correlation analysis was used to investigate the association of WMH volume with cognitive function and specific cognitive domains.Results Compared with the control group,the AD group had significantly higher levels of deep white matter hyperintensities(DWMH),periventricular white matter hyperintensities(PVWMH),and total WMH(P<0.05).Among the 168 AD patients,there were significant differences in the levels of DWMH,PVWMH,and total WMH between the patients with mild,moderate,and severe cognitive impairment(P<0.05);the patients with severe cognitive impairment had significantly higher levels than those with mild and moderate cognitive impairment(P<0.05),while there were no significant differences between the patients with mild and moderate cognitive impairment(P>0.05).When CREDOS score was used for the grading of DWMH and PVWMH,the results showed that there were no significant differences in total MMSE score and the scores of each subscale between the patients with D1,D2,and D3 grades(P>0.05);however,there were significant differences in total MMSE score and the scores of cognitive domains such as orientation,memory,language ability,executive function,attention,and calculation ability between the patients with P1,P2,and P3 grades(P<0.05),with the lowest scores in the patients with P3 grade and the highest scores in those with P1 grade.The Spearman rank correlation analysis showed that PVWMH was negatively correlated with total MMSE score and the scores of orientation,memory,attention,and calculation ability(P<0.05).Conclusions The level of PVWMH is closely associated with cognitive dysfunction in AD patients and can be used as a predictive factor for cognitive impairment in AD.关键词
阿尔茨海默病/脑白质高信号/认知障碍/深部皮质下白质高信号/脑室旁白质高信号Key words
Alzheimes disease/white matter hyperintensities/cognitive impairment/deep white matter hyperintensities/periventricular white matter hyperintensities分类
医药卫生引用本文复制引用
李冬梅,阚志芸,何锋..脑白质高信号与阿尔茨海默病患者认知障碍程度及认知内容的相关性分析[J].国际神经病学神经外科学杂志,2025,52(6):42-47,6.基金项目
河南省卫生健康委员会项目(LHGJ20210953). （LHGJ20210953）
