백질 고신호 병변이 경도인지장애 환자의 인지영역 기능 저하에 미치는 영향
The Influences of White Matter Hyperintensities on the Specific Cognitive Decline in the Patients with Mild Cognitive Impairment
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: It is still unclear that white matter hyperintensities (WMH) would affect the specific cognitive decline of the patients with mild cognitive impairment (MCI). We explored whether WMH influence the specific cognitive decline to the patient with MCI. Methods: Patients with MCI were recruited from August 2005 to February 2009. We evaluated the degree of WMH by the combination of deep and periventricular WMH. Patients with MCI were divided into groups with minimal (Group I), moderate (Group II) and severe (Group III) hyperintensities by the degree of WMH. Being regarded as subcortical vascular MCI, the patients in the Group III were excluded. According to the affected cognitive domain, patients were divided into amnestic single, amnestic multiple, non-amnestic single and non-amnestic multiple MCI. Results: A total of 156 patients were recruited (118 in Group I and 38 in Group II). Mean score of MMSE was 24.9±3.1 and that of CDR was 0.5±0.1. The most frequent subtype was amnestic multiple MCI (67.9%). There were no differences in the affected cognitive domains and distribution of the MCI subtype between Group I and Group II. However, the frontal cognitive function declined significantly, in proportion to the increasing periventricular WMH. Conclusions: These results suggest that increasing of periventricular WMH may affect to the frontal cognitive decline in patients with MCI.
Abstract
Background: It is still unclear that white matter hyperintensities (WMH) would affect the specific cognitive decline of the patients with mild cognitive impairment (MCI). We explored whether WMH influence the specific cognitive decline to the patient with MCI. Methods: Patients with MCI were recruited from August 2005 to February 2009. We evaluated the degree of WMH by the combination of deep and periventricular WMH. Patients with MCI were divided into groups with minimal (Group I), moderate (Group II) and severe (Group III) hyperintensities by the degree of WMH. Being regarded as subcortical vascular MCI, the patients in the Group III were excluded. According to the affected cognitive domain, patients were divided into amnestic single, amnestic multiple, non-amnestic single and non-amnestic multiple MCI. Results: A total of 156 patients were recruited (118 in Group I and 38 in Group II). Mean score of MMSE was 24.9±3.1 and that of CDR was 0.5±0.1. The most frequent subtype was amnestic multiple MCI (67.9%). There were no differences in the affected cognitive domains and distribution of the MCI subtype between Group I and Group II. However, the frontal cognitive function declined significantly, in proportion to the increasing periventricular WMH. Conclusions: These results suggest that increasing of periventricular WMH may affect to the frontal cognitive decline in patients with MCI.
참고문헌 (27)
- de Groot JC, "Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study", Ann Neurol, 47, pp.145~151 (2000)
- Prins ND, "Cerebral white matter lesions and the risk of dementia", Arch Neurol, 61, pp.1531~1534 (2004)
- Bombois S, "Vascular subcortical hyperintensities predict conversion to vascular and mixed dementia in MCI patients", Stroke, 39, pp.2046~2051 (2008)
- Burns JM, "White matter lesions are prevalent but differentially related with cognition in aging and early Alzheimer disease", Arch Neurol, 62, pp.1870~1876 (2005)
- Kono I, "Do white matter changes have clinical significance in Alzheimer’s disease", Gerontology, 50, pp.242~246 (2004)
- Petersen RC, "Mild cognitive impairment: an Overview", CNS Spect, 13, pp.45~53 (2008)
- Graham JE, "Prevalence and severity of cognitive impairment with and without dementia in an elderly population", Lancet, 349, pp.1793~1796 (1997)
- Winblad B, "Mild cognitive impairment--beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment", J Intern Med, 256, pp.240~246 (2004)
- Kang Y, "A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~308 (1997)
- 구형모, "일상활동평가-복합(Seoul-Instrumental Activities of Daily Living ; S-IADL)의 신뢰도 및 타당도 연구", 신경정신의학, 43(2), pp.189~199 (2004), 대한신경정신의학회
- Choi SH, "Estimating the validity of the Korean version of expanded clinical dementia rating (CDR) scale", J Korean Neurol Assoc, 19, pp.585~591 (2001)
- Kang Y, "Seoul neuropsychological screening battery (SNSB)" (2003), Human Brain Research & Consulting Co
- Galluzzi S, "Distinctive clinical features of mild cognitive impairment with subcortical cerebrovascular disease", Dement Geriatr Cogn Disord, 19, pp.196~203 (2005)
- Selden NR, "Trajectories of cholinergic pathways within the cerebral hemispheres of the human brain", Brain, 121, pp.2249~2257 (1998)
- Swan GE, "Biobehavioral characteristics of nondemented older adults with subclinical brain atrophy", Neurology, 54, pp.2108~2114 (2000)
- Cummings JL, "Frontal-subcortical circuits and human behavior", J Psychosom Res, 44, pp.627~628 (1998)
- Portet F, "Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer’s Disease", J Neurol Neurosurg Psychiatry, 77, pp.714~718 (2006)
- Petersen RC, "Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology", Neurology, 56, pp.1133~1142 (2001)
- Petersen RC, "Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome", Arch Neurol, 56, pp.303~308 (1999)
- 임준성, "경도인지장애의 아형 분류와 임상 양상", 대한신경과학회지, 23(3), pp.348~355 (2005), 대한신경과학회
- 보건복지가족부, "치매유병률조사", ~ (2009)
- Debette S, "Subcortical hyperintensities are associated with cognitive decline in patients with mild cognitive impairment", Stroke, 38, pp.2924~2930 (2007)
- Yoshita M, "Extent and distribution of white matter hyperintensities in normal aging, MCI, and AD", Neurology, 67, pp.2192~2198 (2006)
- Wu M, "A fully automated method for quantifying and localizing white matter hyperintensities on MR images", Psychiatry Res, 148, pp.133~142 (2006)
- Kuller LH, "Risk factors for dementia in the cardiovascular health cognition study", Neuroepidemiology, 22, pp.13~22 (2003)
- Vermeer SE, "Silent brain infarcts and the risk of dementia and cognitive decline", N Engl J Med, 348, pp.1215~1222 (2003)
- Garde E, "Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study", Lancet, 356, pp.628~634 (2000)