Objective To investigate volume differences in regional gray matter between patients suffered from mild cognitive impairment associated with periventricular white matter hyperintensities (PWMH) and strategic single-infarct (SSI)by using voxel-based morphometry (VBM) method.Methods Participants were neuropsychologically tested to characterize cognitive function,and then 24 cases of cerebral infarction in patients with mild cognitive impairment were collected and underwent MR scan.According to the results,the patients were divided into PWMH group (n=14) and SSI group (n=10).Meanwhile,16 healthy controls (control group) in the same period were included,whose neuropsychological testing were normal and no obvious infarct was found on MRI.Whole brain regional differences in gray matter volume among 3 groups were examined with VBM.Results Compared with SSI group,the volume of bilateral temporal lobe and bilateral frontal gray matter obviously reduced in PWMH group,especially in bilateral temporal lobes.The lobe atrophy volume difference of left temporal was 4086 voxels,of the right temporal lobe was 4154 voxels,of the left and right frontal lobe was 1718 voxels and 1141 voxels,respectively.Conclusion The volume of regional gray matter between patients with SSI and PWMH shows significant difference.The characteristics of gray matter atrophy in PWMH are similar to degenerative disease,prompting that merger or secondary neurodegenerative changes in this vascular cognitive impairment subtypes can not be ruled out.%目的 利用基于体素的形态测量学(VBM)方法观察由皮质下微血管病变导致的脑室周围白质脱髓鞘(PWMH)后轻度认知障碍的患者与关键部位单发梗死(SSI)后轻度认知障碍的患者灰质萎缩的差异.方法 根据神经心理学测试结果收集24例具有轻度认知障碍的脑梗死患者,根据MRI结果将其分为PWMH组(n=14)和SSI组(n=10)；另选同期16名神经心理学测试结果正常、脑实质内未见明显梗死灶者作为对照组.对所有受检者行高分辨力结构MR扫描后进行VBM分析,比较组间灰质体积的差异.结果 与SSI组相比,PWMH组双侧额叶及颞叶灰质体积明显缩小,以双侧颞叶明显,左侧颞叶萎缩体素差为4086个,右侧颞叶为4154个,左侧额叶为1718个,右侧额叶为1141个.结论 PWMH患者与SSI患者具有不同的灰质萎缩特点.PWMH与神经退行性改变具有相似的灰质萎缩特点,提示该类型的血管性认知障碍可能合并或继发于神经退行性改变.
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