《中国康复理论与实践》

《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (12): 1095-1097.

• 临床研究 • 上一篇    下一篇

测评Binswanger型皮质下血管性痴呆的胆碱能通路白质病变的新型MRI量表

冯涛; 王拥军; 芦林龙; 李伟; 史伟雄; 唐鹤飞   

  1. 首都医科大学附属北京天坛医院神经内科,北京市 100050
  • 收稿日期:2006-10-10 出版日期:2006-12-01 发布日期:2006-12-01

MRI Rating of White Matter Hyperintensities within Cholinergic Pathway and Vascular Dementia in Binswanger's Disease

FENG Tao,WANG Yong-jun, LULin-long, et al   

  1. The Department of Neurology, Beijing Tiantan Hospital, Beijing 100050, China
  • Received:2006-10-10 Published:2006-12-01 Online:2006-12-01

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被引次数

1

摘要： 目的探讨测评Binswanger型皮质下血管性痴呆的胆碱能通路损伤程度的新型量表。方法对41例Binswanger皮质下血管性痴呆患者的MRI片采用Bocti胆碱能通路高信号评分量表(CHIP评分),选择4个特定的轴位片,对10个解剖部位内损伤胆碱能通路的白质病变程度进行评分,同时采用Mattis痴呆量表(DRS)评定认知障碍程度,对导致胆碱能通路损伤的白质病变CHIP评分与DRS评分进行相关性分析。结果41例患者总的CHIP评分为(35.6±13.7)分,DRS总评分(105.6±18.2)分,DRS注意力评分(29.5±4.2)分,DRS记忆力评分(11.3±3.2)分;CHIP评分与DRS评分有相关性(r=-0.43,P<0.05),这种相关性与年龄和受教育程度无关。结论皮质下血管性痴呆中的Binswanger型患者认知障碍的程度可能与其白质病变中胆碱能通路的损害程度相关,CHIP评分可评估损害程度。

关键词: 血管性痴呆, 胆碱能通路, 脑白质, 磁共振成像

Abstract: Objective To investigate the relationship between MRI rating of white matter hyperintensities (WMH) within cholinergic pathway and vascular dementia in Binswanger's disease.Methods 41 patients with Binswanger's disease undergone inspection of MRI. On 4 selected axial images, the severity of WMH in the cholinergic pathways was rated on a 3-point scale for ten regions identified with major anatomical landmarks. The cholinergic pathways hyperintensities scale (CHIPS) were developed by Bocti based immunohistochemical tracings of the cholinergic pathways. Subjects underwent neuropsychological testing with the Mattis Dementia Rating Scale (DRS) to assess cognitive domains of interest (attention, episodic memory, executive functions). Spearman correlation coefficients were used to compute association between CHIPS score and DRS score.Results The total score of DRS, the scores of DRS attention subscale and memory subscale were 105.6±18.2, 29.5±4.2 and 11.3±3.2 respectively. The score of CHIPS was 35.6±13.7. After accounting for age and education in a multiple linear regression model, the CHIP ratings were associated with impaired performance on the DRS ( r=-0.43, P<0.05).Conclusion The MRI rating of WMH within cholinergic pathway has strong correlations with cognitive performance in patients with Binswanger's disease.

Key words: vascular dementia, cholinergic pathway, white matter, magnetic resonance imaging (MRI)