脑白质病变对认知功能的影响

摘要

Aim; To investigate the cognitive function impairment of patients with cerebral white matter lesion (WML) at different extent and different location. Methods: According to MRI T2 weighted -imaging and FLAIR imaging ,75 patients were first classified into 3 subgroups (mild, moderate , and severe) depending on the extent , then were classified into 2 subgroups (periventricular lesions and deep WML ) depending on the location. Thirty normal people were regarded as control group. Cognitive performance was assessed using the Montreal Cognitive Assessment ( MoCA). ReSUltS: Compared with control , WML group had significantly low scores in total MoCA score , visual spatial, executive function , language , memory and o-rientation. Moderate and severe subgroups had significantly low scores in attention,calculation and abstraction ; severe subgroup had significantly low scores in naming (P < 0. 05). The periventricular lesion subgroup had significantly low scores in total MoCA score , calculation , language , abstraction, memory and orientation , and insignificantly high scores in visual spa -tial, executive function or attention compared with deep WML subgroup . Conclusion: Patients with WML undergo cognitive function impairment, especially in visual spatial, executive function , language , abstraction, memory and orientation. Periventricular and deep WML may have different influence on cognitive function .%目的:探讨不同部位和不同程度脑白质病变(WML)对患者认知功能的影响.方法:选择WML患者75例和正常对照组30例.根据头颅MRI T2加权像及FLAIR像,将WML组患者分为脑室旁白质病变组和深部白质病变组,根据病变严重程度分为轻度、中度及重度组,应用蒙特利尔认知功能评估量表(MoCA)对入选对象进行认知功能评估.结果:与正常对照组相比,WML组MoCA量表总分、视空间与执行功能、语言、延迟回忆和定向功能均降低(P均<0.01);中度、重度病例组注意力、计算功能、抽象功能得分较差(P<0.05),重度病例组命名功能得分下降(P<0.05).室旁白质病变组MoCA量表总分、计算、语言、抽象、延迟回忆和定向功能较深部白质病变组得分较低,而视空间与执行功能、注意力得分差异无统计学意义.结论:WML患者视空间与执行功能、语言、抽象功能、延迟回忆和定向力等多个认知领域受损;脑室旁和深部WML对认知功能的影响可能有所不同.