CAJ | 학술논문

目的：研究先兆偏头痛患者的认知功能障碍与脑白质疏松（ LA）的关系。方法收集56例先兆性偏头痛患者（偏头痛组）和60例健康对照者（正常对照组）的资料。 LA的严重程度用基于3．0T MRI 的皮质下胆碱能通路高信号量表（ CHIPS）进行评价。在偏头痛发作期和间歇期，分别给患者进行Mattis痴呆评定量表（DRS）测评；并与正常对照者比较。结果偏头痛组LA的比率（43例，76．8％）及CHIPS评分[24（3．75～28）分]均显著高于正常对照组[16例，26．7％；0（0～8．75）分]（均P＜0.001）。偏头痛组发作期的DRS总分、启动与保持、概念化、结构和记忆因子分显著低于正常对照组（P＜0．05～0．001），注意因子评分的差异无统计学意义。偏头痛组间歇期的DRS总分显著低于正常对照组（P＜0．05）；发作期DRS总分、记忆因子评分显著低于间歇期（均P＜0．001）。偏头痛患者发作期的DRS总分和记忆分与CHIPS评分间呈负相关（r＝-0.326，P＝0.014；r＝-0.356，P＝0.007），其他4个因子评分及间歇期的所有评分与CHIPS评分间均无相关性。结论先兆偏头痛患者有认知功能障碍，在发作期尤其显著，并与LA的程度有关。
목적：연구선조편두통환자적인지공능장애여뇌백질소송（ LA）적관계。방법수집56례선조성편두통환자（편두통조）화60례건강대조자（정상대조조）적자료。 LA적엄중정도용기우3．0T MRI 적피질하담감능통로고신호량표（ CHIPS）진행평개。재편두통발작기화간헐기，분별급환자진행Mattis치태평정량표（DRS）측평；병여정상대조자비교。결과편두통조LA적비솔（43례，76．8％）급CHIPS평분[24（3．75～28）분]균현저고우정상대조조[16례，26．7％；0（0～8．75）분]（균P＜0.001）。편두통조발작기적DRS총분、계동여보지、개념화、결구화기억인자분현저저우정상대조조（P＜0．05～0．001），주의인자평분적차이무통계학의의。편두통조간헐기적DRS총분현저저우정상대조조（P＜0．05）；발작기DRS총분、기억인자평분현저저우간헐기（균P＜0．001）。편두통환자발작기적DRS총분화기억분여CHIPS평분간정부상관（r＝-0.326，P＝0.014；r＝-0.356，P＝0.007），기타4개인자평분급간헐기적소유평분여CHIPS평분간균무상관성。결론선조편두통환자유인지공능장애，재발작기우기현저，병여LA적정도유관。
Objective To investigate the relationship between cognitive impairment and leukoaraiosis ( LA) in patients with migraine with aura .Methods Fifty-six patients with migraine with aura ( migraine group ) and sixty normal controls ( normal control group ) were recruited .The severity of LA was rated on the cholinergic pathways hyperintensities scale(CHIPS) based on 3.0T MRI scan.Cognitive function of migraine patients were measured by the Mattis dementia rating scale ( DRS ) in their acute attack period and intermission period , and compared with normal controls.Results Migraine group showed the significantly higher incidence of LA (76.8%, n=43) and the CHIPS score[24(3.75~28)〗than those of control group (incidence:26.7%, n=16;the CHIPS score [0(0~8.75)〗) (all P<0.001 ).The DRS total score and its four sub -factors including initiation/perseveration, conceptualization , construction and memory were significantly lower in the acute attack period of patients with migraine with aura compared to control group ( P<0.05 ~0.001), while no significant difference was found in attention sub-factor.The DRS total score was significantly lower in the intermission period of patients with migraine with aura compared with control group (P<0.05).The DRS total score and memory sub -factor of patients with migraine with aura were significantly lower in the acute attack period than the intermission period (all P<0.001). The CHIPS score was negatively correlated with DRS total score and memory factor score ( r=-0.326, P=0.014;r=-0.356, P=0.007) in the acute attack period of the patients with migraine with aura .There were no significant correlations between CHIPS score and the other four sub-factors in the acute attack period and all scores in intermission period of the patients with migraine with aura .Conclusion The patients with migraine with aura have cognitive impairment , especially in the acute attack period , which is associated with the severity of LA .