摘要
目的探讨社区老年人群中血管源性脑白质高信号(WMH)消退与认知功能的关联。方法本研究纳入上海老年队列中基线无痴呆或脑卒中病史且具有基线和随访影像资料以及认知功能评估的社区老年人群。采用基于U-Net模型的自动分割技术量化WMH体积,根据纵向体积改变将所有受试者分为WMH消退组、进展组和稳定组。使用广义线性模型分析WMH消退与随访认知功能的关联。结果本研究共纳入186例社区老年人,中位年龄68岁,男性81例(43.5%)。经过约6.6年随访,156例(83.9%)出现WMH进展,20例(10.8%)出现WMH消退,10例(5.4%)的WMH体积保持相对稳定,各组WMH体积改变比较,差异均有统计学意义(均P<0.001)。消退组受试者的基线WMH体积较进展组和稳定组更大(P=0.013),3组的血管危险因素、其他脑小血管病影像标志物和基线认知功能的差异均无显著性。校正年龄、性别及随访时间后,WMH消退组的随访执行功能(β=-0.94,95%CI:-1.80~-0.08,P=0.031)显著优于稳定组。结论在社区老年人群中,WMH消退可能与执行功能相对保留有关。
Aim To explore the association between regression of white matter hyperintensity of presumed vascular origin(WMH)and cognitive function in the community-dwelling elderly.Methods Community-dwelling elderly without history of stroke or dementia was included from the Shanghai Aging Study,who had available brain magnetic resonance imaging(MRI)scans and cognitive function assessments at baseline and follow-up.WMH volume was automatically segmented and quantified based on the U-net model.All subjects were divided into a WMH regression group,a progression group,and stable group based on longitudinal volume changes.The association between WMH regression and follow-up cognitive function was analyzed by generalized linear models.Results A total of 186 elderly was included,the median age was 68 years and 81(41.5%)were males.After about 6.6 years of follow-up,156(83.8%)showed WMH progression,20(10.8%)participants exhibited WMH regression,and the rest 10(5.4%)remained relatively stable.There were significant differences in WMH volume changes among the three groups(P<0.001).The baseline WMH volume of WMH regression group was larger than the progression and stable groups(P=0.013).No significant difference was found in vascular risk factors,other imaging markers of cerebral small vessel disease,or baseline cognitive functions among the three groups.After adjusting age,sex,and follow-up time,follow-up executive function of subjects in the WMH regression group was notably better than the WMH stable group(β=-0.94,95%CI:-1.80~-0.08,P=0.031).Conclusion Among the community-dwelling elderly,regression of white matter hyperintensity of presumed vascular origin is potentially associated with relative preservation of executive function.
作者
曹瑾怡
仲伟逸
夏忆玮
王潇潇
梁宗辉
丁玎
程忻
CAO Jin-yi;ZHONG Wei-yi;XIA Yi-wei;WANG Xiao-xiao;LIANG Zong-hui;DING Ding;CHENG Xin(Department of Neurology,Huashan Hospital,Fudan University,Shanghai 200040,China;National Medical Center for Neurological Diseases,Shanghai 200040,China;National Clinical Research Centre for Aging and Medicine,Shanghai 200040,China;Center for Biomedical Imaging,University of Science and Technology of China,Hefei 230026,China;Department of Radiology,Jing’an District Center Hospital,Shanghai 200040,China)
出处
《中国临床神经科学》
2025年第2期200-209,220,共11页
Chinese Journal of Clinical Neurosciences
基金
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项(编号:2023ZD0504903)。
关键词
脑小血管病
磁共振成像
白质高信号
认知功能
消退
cerebral small vessel disease
magnetic resonance imaging
white matter hyperintensity
cognitive function
regression
