BACKGROUND:It has been shown that symptomatic or severe carotid atherosclerosis is closely related to cognitive impairment and brain white matter damage. However, there is still a lack of effective and non-invasive imaging biomarkers to identify early high-risk cerebrovascular diseases. Therefore, the purpose of this study is to explore the integrity of brain white matter and cognitive impairment in patients with asymptomatic carotid plaques by using imaging technology.
METHODS:All subjects were from a project of Stroke Risk Screening and Prevention and were defined as stroke high-risk patients (with three or more stroke risk factors). Tract-based spatial statistics (TBSS) based on diffusion tensor imaging (DTI) was used to analyze the whole brain white matter abnormalities in 61 patients with carotid artery plaque and in 40 healthy controls. At the same time, the general clinical data between the two groups were compared, such as age, gender, smoking, hypertension and cognitive function scores etc. Furthermore, the plaque group was divided into the have-hyperintensities group and the no-hyperintensities group to compare their microstructure of white matter injuries.
RESULTS:The cognitive scores of plaque group were significantly lower than that of control group. We found that when plaque group and control group were compared, no white matter fiber tracts with difference was found in FA, MD, AD and RD. However, the decrease of FA and the increase of RD were found in some white matter regions (P < 0.05) when comparing the have-hyperintensities group and the no-hyperintensities group. These white matter regions included anterior thalamic radiation, corticospinal tract, cingulum (cingulate gyrus), forceps minor, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus. What's more, there were significant differences in blood pressure between the two groups.
CONCLUSION:The cognitive function of patients with early high-risk cerebrovascular diseases (asymptomatic carotid plaques) has a downward trend. TBSS based on DTI can help to find out the actual damage of brain white matter in patients with early carotid plaque, and reflect the early pathological changes from the micro level.
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【Micro-structural white matter abnormalities and cognitive impairment in asymptomatic carotid plaque patients: A DTI study using TBSS analysis.].
【无症状性颈动脉斑块患者的微结构白质异常和认知障碍：使用TBSS分析的DTI研究。】
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DOI：10.1016/j.clineuro.2020.106096文章类型：杂志文章
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背景：有症状或严重的颈动脉粥样硬化与认知障碍和脑白质损害密切相关。然而，仍然缺乏有效的和非侵入性的成像生物标记物来鉴定早期的高危脑血管疾病。因此，本研究的目的是通过影像技术探讨无症状性颈动脉斑块患者脑白质的完整性和认知障碍。
方法：所有受试者均来自中风风险筛查和预防项目，被定义为中风高危患者（具有三个或更多中风风险因素）。基于扩散张量成像（DTI）的基于空间的空间统计（TBSS）被用于分析61例颈动脉斑块患者和40例健康对照者的全脑白质异常。同时比较两组患者的一般临床资料，如年龄，性别，吸烟，高血压和认知功能评分等。此外，斑块组分为高血脂组和无高血脂组。比较他们的白质损伤的微观结构。
结果：斑块组的认知评分明显低于对照组。我们发现，当将斑块组和对照组进行比较时，在FA，MD，AD和RD中没有发现具有差异的白质纤维束。但是，与高血脂组和无高血脂组相比，在某些白质区域中，FA的减少和RD的增加（P <0.05）。这些白质区域包括丘脑前部放射线，皮质脊髓束，扣带回（扣带回），小镊子，额枕下筋膜，纵向上筋膜，束状筋膜。此外，两组之间的血压存在显着差异。
结论：早期高危脑血管疾病（无症状性颈动脉斑块）患者的认知功能呈下降趋势。基于DTI的TBSS可以帮助找出早期颈动脉斑块患者脑白质的实际损害，并从微观水平反映出早期病理变化。
方法：所有受试者均来自中风风险筛查和预防项目，被定义为中风高危患者（具有三个或更多中风风险因素）。基于扩散张量成像（DTI）的基于空间的空间统计（TBSS）被用于分析61例颈动脉斑块患者和40例健康对照者的全脑白质异常。同时比较两组患者的一般临床资料，如年龄，性别，吸烟，高血压和认知功能评分等。此外，斑块组分为高血脂组和无高血脂组。比较他们的白质损伤的微观结构。
结果：斑块组的认知评分明显低于对照组。我们发现，当将斑块组和对照组进行比较时，在FA，MD，AD和RD中没有发现具有差异的白质纤维束。但是，与高血脂组和无高血脂组相比，在某些白质区域中，FA的减少和RD的增加（P <0.05）。这些白质区域包括丘脑前部放射线，皮质脊髓束，扣带回（扣带回），小镊子，额枕下筋膜，纵向上筋膜，束状筋膜。此外，两组之间的血压存在显着差异。
结论：早期高危脑血管疾病（无症状性颈动脉斑块）患者的认知功能呈下降趋势。基于DTI的TBSS可以帮助找出早期颈动脉斑块患者脑白质的实际损害，并从微观水平反映出早期病理变化。
