大脑MRI检查结果和认知功能的关系:动脉粥样硬化风险的社区研究

作     者：Mosley Jr. T.H. Knopman D.S. Catellier D.J. 张殿增 

作者机构：Department of Medicine (Geriatrics) University of Mississippi Medical Center 2500 North State Street Jackson MS 39216-4505 United States Dr. 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第10期

页      面：49-50页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：认知功能 MRI检查结果 社区研究 队列研究 异常发生率 中央沟 放射科医师 流畅度 无症状 点量表 

摘      要：Objective: To examine the association between prevalent cerebral abnormalitie s identified on MRI and cognitive functioning in a predominantly middle- aged, population- based study cohort. Methods: Cerebral MRI was performed on 1,538 in dividuals (aged 55 to 72) from the Atherosclerosis Risk in Communities (ARIC) co hort, with no history of stroke or TIA, at study sites in Forsyth County, NC, an d Jackson, MS. White matter hyperintensities (WMHs)- , ventricular size, and su lcal size were graded by trained neuroradiologists on a semiquantitative, 10- p oint scale. Cognitive functioning was assessed using the Delayed Word Recall Tes t (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT). Re sults: High ventricular grade was independently associated with significantly lo wer scores on the DWRT and DSST and greater risk (odds ratio [OR] 2.32, 95% co nfidence interval [CI] 1.51 to 3.56) of impaired scores (i.e., 10th percentile ) on the DWRT. High sulcal grade was associated with a modest decrement in score s on the DWRT. The presence of coexisting high grade WMHs and silent infarcts wa s independently associated with lower scores on all cognitive tests and greater risk of impaired functioning on the DSST (OR 2.91, 95% CI: 1.23 to 6.89) and W FT (OR 2.28, 95% CI 1.03 to 5.08). The presence of two or more high- grade ab normalities was as sociated with increased risk of impaired functioning on all cognitive tests ( DWRT: OR 2.23, 95% CI 1.40 to 3.55; DSST: OR 2.06, 95% CI 1.13 to 3.76; WFT: OR 2.07, 95% CI 1.23 to 3.49) independent of multiple covariates and silent i nfarcts. Conclusion: Common changes in brain morphology are associated with dimi nished cognitive functioning in middle- aged and young- elderly individuals.