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알츠하이머병과 경도인지손상 환자에서 백질 고강도와 인지기능장애와의 연관성

The Association of Cognitive Dysfunction with White Matter Hyperintensity in Alzheimer’s Disease and Mild Cognitive Impairment

기백석|이영식|최태영|한덕현|민경준|나철|박두병|나형일|윤성구|안영균
대한신경정신의학회 (Korean Neuropsychiatric Association)|2009.07|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제48권 제4호|pp. 287-293

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참고문헌

키워드

백질 고강도·알츠하이머병·경도인지손상White matter hyperintensity·Alzheimer’s disease·mild cognitive impairment
주제분류정신과학

초록

T2 강조 MRI에서 보이는 백질 고강도는 반복적인 허혈 성 손상이 백질의 구조적 변화를 일으켜서 발생한다. 이와 같은 백질 고강도는 아밀로이드 혈관병증이 많이 동반되는 AD와 연관성이 있으며 백질 부위에 따라서 인지기능 저하 에 차이를 보인다. 백질은 해부 및 병리적인 차이로 뇌실주 위 백질과 심부 백질로 나뉘어지는데, 뇌실주위 백질 고강도 는 기억력 저하, 고위수행장애 및 집중력/계산력에서 인지 기능 저하를 보였으며 심부 백질 고강도는 집중력/계산력에 서 인지기능 저하를 보였다.

Abstract

Objectives We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Methods T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Dia-gnoses System. Results No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. Conclusion Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention.

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