论文部分内容阅读
目的:探讨不同部位脑白质病变(WML)与认知功能的相关性。方法:应用蒙特利尔认知评估量表(MoCA)对2019年1月至2020年5月在首都医科大学电力教学医院收治的68例WML患者的认知功能进行测评,应用与年龄相关的脑白质改变分级量表(ARWMCRs)对WML的严重程度进行评分,分析不同病变部位ARWMCRs评分及总分与认知功能总评分之间的相关性,以及不同病变部位ARWMCRs评分与认知功能各子项之间的关系。结果:68例WML患者不同部位病变程度由重到轻依次为:额区、顶枕区、基底节区及颞区,幕下区未发现白质病变。除基底节区以外,其余区域ARWMCRs评分及总分均与MoCA评分呈负相关,其中左额、右额、左顶枕及右顶枕区与MoCA评分的相关性最强(n rn s=-0.388、- 0.479、- 0.418、- 0.502,均n P<0.01)。WML患者左额区与语言、抽象及定向力呈负相关(n rn s=-0.479、- 0.324、- 0.288,均n P<0.01);右额区与视空间执行功能、记忆力、语言、抽象及定向力呈负相关(n rn s=-0.324、- 0.272、- 0.459、-0.382、- 0.352,均n P<0.05);左顶枕区与视空间执行功能及记忆力呈负相关(n rn s=- 0.287、- 0.270,均n P<0.05);右顶枕区与记忆力、语言、抽象及定向力呈负相关(n rn s=- 0.366、- 0.289、- 0.260、- 0.307,均n P<0.05);左颞区与语言、抽象及定向力呈负相关(n rn s=- 0.248、- 0.372、- 0.608,均n P<0.05);右颞区与抽象及定向力呈负相关(n rn s=- 0.525、- 0.465,均n P<0.01);右基底节区与定向力及记忆力呈负相关(n rn s=- 0.455、- 0.275,均n P<0.01);左基底节区与MoCA各子项无相关性。n 结论:WML患者额区及顶枕区白质病变最严重,这两个区域病变所导致的认知功能损害范围也最广。“,”Objective:To explore the correlation between white matter lesions (WML) at different locations and cognitive function.Methods:The cognitive function of 68 patients with WML in Beijing Electric Power Hospital from January 2019 to May 2020 were assessed with Montreal Cognitive Assessment Scale (MoCA), and the extent of WML were assessed with age-related white matter changes rating scale(ARWMCRs). Correlation between the ARWMCRs scores of different locations and the scores of all locations and the scores of cognitive function, as well as the relationship between the ARWMCRs scores of different locations and each subitem of cognitive function were analyzed.Results:In 68 patients with WML, the degree of lesions in different parts from heavy to light was frontal area, parietooccipital area, basal ganglia area and temporal area, and no white matter lesions were found in infratentorial area. Except the basal ganglia region, the ARWMCRs scores in other regions and the total score were negatively correlated with MoCA score, among which, the ARWMCRs score in left frontal area, right frontal area, left parietal pillow and right parietal pillow region had the strongest correlation with MoCA score(n rs=- 0.388, - 0.479, -0.418, -0.502, all n P<0.01).In WML patients, the left frontal area was negatively correlated with language, abstraction and orientation (n rs=- 0.479, - 0.324, - 0.288, all n P<0.01).The ARWMCRs score in right frontal area was negatively correlated with visual spatial and executive function, memory, language, abstraction, and orientation (n rs=- 0.324, -0.272, -0.459, -0.382, -0.352, all n P<0.05). The ARWMCRs score in left parietal occipital region was negatively correlated with visual spatial and executive function and memory (n rs =-0.287、- 0.270, all n P<0.05). The ARWMCRs score in right parietal occipital region was negatively correlated with memory, language, abstraction and orientation (n rs=-0.366, -0.289, -0.260, - 0.307, all n P<0.05).The ARWMCRs score in left temporal region was negatively correlated with language, abstraction and orientation (n rs=- 0.248, -0.372, - 0.608, all n P<0.05).The ARWMCRs score in right temporal region was negatively correlated with abstraction and orientation (n rs=- 0.525, -0.465, all n P<0.01).The ARWMCRs score in right basal ganglia was negatively correlated with orientation and memory (n rs=- 0.455, - 0.275, all n P<0.01), while The ARWMCRs score in left basal ganglia was not correlated with MoCA subitems.n Conclusions:The frontal area and parietal occipital area are the most serious lesions in WML patients, and the lesions in these two areas also cause the widest range of cognitive impairment.