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논문KCI 등재

카다실 환자의 주요혈관인지장애와 경도혈관인지장애에서 뇌 자기공명영상 표지자가 미치는 영향

Impact of Brain MRI Markers on Major and Mild Vascular Cognitive Impairment in CADASIL

고명주|이호규|이정석|최재철
대한신경과학회 (Korean Neurological Association)|2022.02|대한신경과학회지 (Journal of the Korean Neurological Association)|제40권 제1호|pp. 39-46

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참고문헌

키워드

Brain MRIVCIBPFCADASIL
주제분류신경과학

초록

Background: Cognitive impairment is the second most common clinical manifestation in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). However, understanding of cognitive impairment in CADASIL has been hampered by lack of consensus on diagnosis of vascular cognitive impairment (VCI). We used vascular impairment of cognition classification consensus study principles (VICCCS-1) and protocols (VICCCS-2) to assess the cognitive impairment in CADASIL. We also evaluated the impact of MRI markers on major and mild VCI in CADASIL. Methods: We prospectively recruited 64 patients who underwent standardized brain MRI and detailed neuropsychological test. MRI analysis included number of lacunes, number of cerebral microbleeds (CMB), normalized volume of white-matter hyperintensities (nWMH), and brain parenchymal fraction (BPF). BPF has been used to measure brain atrophy. The patients were divided into three groups: those with normal cognition (CADASIL-NC, n=14), those with mild VCI (CADASIL-mild VCI, n=38), and those with major VCI (CADASIL-major VCI, n=11). Results: The three groups differed according to age, with the major VCI group being older. The major VCI group had more lacunes, more CMB, more extensive white matter lesions and lower BPF than NC group. There were no significant differences between NC and mild VCI groups in BPF. BPF and age were the independent predictors of major VCI. There was a tendency that women were at higher risk for mild VCI, though it did not reach statistical significance. Women were older than men, but had lower number of lacunes in mild VCI. Conclusions: These findings suggest that brain atrophy and age are the main predictors of major VCI in CADASIL.

Abstract

Background: Cognitive impairment is the second most common clinical manifestation in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). However, understanding of cognitive impairment in CADASIL has been hampered by lack of consensus on diagnosis of vascular cognitive impairment (VCI). We used vascular impairment of cognition classification consensus study principles (VICCCS-1) and protocols (VICCCS-2) to assess the cognitive impairment in CADASIL. We also evaluated the impact of MRI markers on major and mild VCI in CADASIL. Methods: We prospectively recruited 64 patients who underwent standardized brain MRI and detailed neuropsychological test. MRI analysis included number of lacunes, number of cerebral microbleeds (CMB), normalized volume of white-matter hyperintensities (nWMH), and brain parenchymal fraction (BPF). BPF has been used to measure brain atrophy. The patients were divided into three groups: those with normal cognition (CADASIL-NC, n=14), those with mild VCI (CADASIL-mild VCI, n=38), and those with major VCI (CADASIL-major VCI, n=11). Results: The three groups differed according to age, with the major VCI group being older. The major VCI group had more lacunes, more CMB, more extensive white matter lesions and lower BPF than NC group. There were no significant differences between NC and mild VCI groups in BPF. BPF and age were the independent predictors of major VCI. There was a tendency that women were at higher risk for mild VCI, though it did not reach statistical significance. Women were older than men, but had lower number of lacunes in mild VCI. Conclusions: These findings suggest that brain atrophy and age are the main predictors of major VCI in CADASIL.

참고문헌 (31)

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카다실 환자에서 뇌졸중발생 유무에 따른 임상증상과 뇌자기공명영상소견의 차이강사윤, 강지훈, 나해리, 송숙근, 송정국, 이정석, 최재철대한신경과학회 · 대한신경과학회지2012 · 제30권 제2호카다실 환자에서 고혈압과 뇌미세출혈의 연관성강사윤, 강지훈, 박선우, 송숙근, 이정석, 최재철대한신경과학회 · 대한신경과학회지2014 · 제32권 제2호CADASIL에서 고혈압이 열공경색과 뇌미세출혈의 발병위치에 미치는 영향강사윤, 강지훈, 송숙근, 오정환, 이정석, 최재철대한치매학회 · Dementia and Neurocognitive Disorders(대한치매학회지)2014 · 제13권 제4호Effects of Lacunar Infarctions on Cognitive Impairment in Patients with Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy강사윤, 강지훈, 나해리, 박지강, 이정석, 최재철대한신경과학회 · Journal of Clinical Neurology2011 · 제7권 제4호R544C Mutation을 가진 CADASIL 환자의 혈관성 위험인자강사윤, 강지훈, 나해리, 이정석, 최재철대한치매학회 · Dementia and Neurocognitive Disorders(대한치매학회지)2009 · 제8권 제2호The Correlation of the White Matter Lesions and Lacunar Infarcts in Patients with Vascular Cognitive Impairment김희영, 이재홍, 정은혜, 주라형대한치매학회 · Dementia and Neurocognitive Disorders(대한치매학회지)2012 · 제11권 제2호

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