CAJ | 학술논문

目的：研究无症状性脑梗死（asymptomatic cerebral infarction，ACI）患者大脑灰质体积与认知功能的关系。方法对38例ACI患者（患者组）和38例健康受试者（对照组）进行全脑3DT1W扫描，采用基于体素的形态学分析法（voxel based morphometry，VBM）分析磁共振数据。对所有受试者进行P300测查，采用t检验比较两组脑灰质体积的差异，提取患者组差异脑区灰质体积，与蒙特利尔认知评估量表（Montreal Cognitive Assess-ment ，MoCA），P300波幅、潜伏期，年龄及受教育程度进行相关分析。结果与对照组比较，患者组灰质体积降低的脑区分布在左侧额叶上下回，双侧颞叶上回，右侧颞中回，双侧海马回及双侧小脑前叶（P＜0.01，FDR校正）；未发现有体积增高的脑区。Pearson相关分析显示ACI组MoCA量表评分、P300波幅与患者组额叶及颞叶体积正相关（r≥0.62, P＜0.01）；P300潜伏期与额叶，颞叶，海马体积负相关（r≤-0.71, P＜0.05）；未发现各个异常脑区体积与患者年龄、受教育程度、汉密尔顿抑郁量表(Hamilton Depression Scale，HDRS)评分和汉密尔顿焦虑量表（Hamilton Anxiey Scale，HAMA）评分存在相关，未发现小脑体积与各临床特征因子存在相关。结论 ACI患者存在多个脑区的灰质体积减少，这可能是ACI患者认知功能损害的神经影像学机制。
목적：연구무증상성뇌경사（asymptomatic cerebral infarction，ACI）환자대뇌회질체적여인지공능적관계。방법대38례ACI환자（환자조）화38례건강수시자（대조조）진행전뇌3DT1W소묘，채용기우체소적형태학분석법（voxel based morphometry，VBM）분석자공진수거。대소유수시자진행P300측사，채용t검험비교량조뇌회질체적적차이，제취환자조차이뇌구회질체적，여몽특리이인지평고량표（Montreal Cognitive Assess-ment ，MoCA），P300파폭、잠복기，년령급수교육정도진행상관분석。결과여대조조비교，환자조회질체적강저적뇌구분포재좌측액협상하회，쌍측섭협상회，우측섭중회，쌍측해마회급쌍측소뇌전협（P＜0.01，FDR교정）；미발현유체적증고적뇌구。Pearson상관분석현시ACI조MoCA량표평분、P300파폭여환자조액협급섭협체적정상관（r≥0.62, P＜0.01）；P300잠복기여액협，섭협，해마체적부상관（r≤-0.71, P＜0.05）；미발현각개이상뇌구체적여환자년령、수교육정도、한밀이돈억욱량표(Hamilton Depression Scale，HDRS)평분화한밀이돈초필량표（Hamilton Anxiey Scale，HAMA）평분존재상관，미발현소뇌체적여각림상특정인자존재상관。결론 ACI환자존재다개뇌구적회질체적감소，저가능시ACI환자인지공능손해적신경영상학궤제。
Objective To explore the cognitive features of the patients with asymptomatic cerebral infarction (ACI)and its correlation with the cerebral gray matter volumes. Methods The 3DT1W data and P300 data were obtained from 38 ACI patients and 38 health controls (HC). The MRI dates were analyzed by using voxel based morphometry (VBM). We extracted the values of cerebral gray matter volume in the abnormal regions of ACI patients. Correlation analy-ses were performed in ACI patients to analyze the association between the values of cerebral gray matter volume and the scores of Montreal Cognitive Assessment (MoCA) Scale,P300 latency,P300 amplitude,age and education. Results Com-pared with controls, ACI patients had significant reduced gray matter volume in the left superior frontal gyrus and inferior frontal gyrus, bilateral superior temporal gyrus,right middle temporal gyrus, bilateral hippocampus and bilateral anterior lobe of the cerebellum(P<0.01,FDR correction). The volume of the frontal and the temporal lobe were positively corre-lated with the score of MoCA scale and P300 amplitudes(r≥0.62, P<0.01). P300 latency was negatively correlated with the volume of the frontal,temporal and hippocampus(r≤-0.71, P<0.05). There were no significant correlations be- tween the gray volumes of the abnormal brain regions and four clinical characteristics in ACI patients. There were no sig-nificant correlations between the gray volumes of the cerebellum and all clinical characteristics were found also. Conclu-sions Gray matter volumes were reduced in multiple brain regions of ACI patients which might be the Neuroimaging mechanism underlying cognitive impairment in ACI.