| Objective To investigate the related factors of Leukoaraiosis to provide clinical evidence for early prevention and intervention.Methods In accordance with the inclusion and exclusion criteria strictly, patients from March 2014 to January 2016 in Tongji Hospital and society volunteers at the age of 50-80 years were continuously recruited and screened. Each selected subject was performed free MRI and MRA examination. Subjects whose MRA indicated obvious cerebral artery stenosis were excluded. Then according to MRI T1-weighted image, T2-weighted images and T2 Flair image and the diagnostic criteria of Leukoaraiosis, the selected subjects were divided into Leukoaraiosis group(LA group) and normal control group(NC group). Based on radiographic score(Fazekas score system was used), those with leukoaraiosis score> = 3 points were included in Leukoaraiosis group and those with leukoaraiosis score< = 2 points were included in normal control group.The general information(name, sex, age, education years, disease history) and biochemical results( blood lipid and glucose, urea, c reatinine, uric acid, CRP and HCY)of each elected subject were collected. Multivariate Binary Logistic regression analysis was used to explore the related risk factors of Leukoaraiosis.Results A total of 155 subjects enrolled was devided into two groups, case group with LA(n=73),and normal NC(n=82). Multivariate Binary Logistic regression analysis showed that hypertension history(p=0.002、OR=6.135), age(p=0.044、OR=1.080)were statistically significant in the constructed regression model.Conclusion Hypertension and age are risk factors in the elder patients with Leukoaraiosis.Objective To investigate the resting state neural synchronous activity characteristics in patients with cognitive impairment or not. Using the regional homogeneity(Reho) method to explore the underlying causes and mechanisms resulting in cognitive functional differences existing between patients with Leukoaraiosis.Methods In accordance with the inclusion and exclusion criteria strictly, patients from March 2014 to January 2016 in Tongji Hospital and society volunteers at the age of 50-80 years were continuously recruited and screened. Each selected subject was given free MRI、MRA and f MRI. Subjects whose MRA indicated cerebral artery stenosis were excluded. Each selected subject was given free neuropsychological scale(MMSE+C DR) to evaluate the overall cognitive function and individual cognitive scale(SDMT, TMT, DST, VFT, AVLT-H, CDT) to evaluate the following five cognitive domains as information processing speed,executive function,episode memory,working memory and visual-spatial abilities respectively. Then according to MRI T1 WI image,T2 WI images,T2 Flair image and neuropsychological score, and the diagnostic criteria of leukoaraiosis and cognitive impairment, the selected subjects were divided into three groups: normal control group(NC),WMH patients with cognitive impairment group(PCI)and WMH patients without cognitive impairment group(Pn CI). Then Brat software was usd to preprocess f MRI data and calculates the whole brain Reho for every subject. Reho was transformated with Fisher Z to better meet normal distribution. One-way ANOVA with covariates included was used to detect group differences in z Reho and define brain region with significant differences as region of interest for the following study. The relationship between Reho of ROI and neuropsychological score was explored using Spearman’s partial correlation analysis.Results A total of 123 subjects enrolled was devided into three groups: NC group 55 cases,PCI group 23 cases and Pn CI group 43 cases. Reho analysis showed that compared with NC group, Pn CI group showed obviously increased Reho(p<0.05)in left precuneus, left cuneus, the left middle occipital gyrus, right cuneus, right precuneus, left lingual gyrus, left calcarine surrounding cortex; Compared with Pn CI group, PCI group showed obviously decreased Reho(p<0.05)in left precuneus, left cuneus, posterior cingulate, right lingual gyrus, the left middle occipital gyrus, right cuneus, right precuneus, left lingual gyrus, left calcarine surrounding cortex; Compared with NC group, PCI group showed obviously increased Reho(p<0.05)in left precuneus, left cuneus, posterior cingulate, right lingual gyrus. Partial correlation analysis showed Reho was positively correlated to neuropsychological score.Conclusion Cognitive differences is indeed present among patients with Leukoaraiosis.Compared with the NC group, Pn CI group Reho showed a significantly increasing trend. Compared with the Pn CI group, PCI Reho group showed a significantly decreasing trend. Correlation analysis showed Reho was positively correlated to neuropsychological score.Whether leukoaraiosis can cause cognitive dysfunction may include very complex potential mechanisms such as cortical remodeling. Increased regional homogeneity may play a compensatory role before cognitive impairment occurs occurs.To some degree, the loss of regional homogeneity’s compensatory role may cause cognitive impairment. |
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