| Background With the aging of the population, the incidence rate of Alzheimer’s disease(AD) was gradually rising and AD had become an important disease threat to life and health of the elderly population. Because the early diagnosis is very difficult, it’s very hard for the early diagnosis of Alzheimer’s disease with poorly means of diagnosis. In the aspect of clinical symptoms, the main clinical symptoms of AD are cognitive dysfunction, personality change and psychiatric symptoms,where the typical pathological changes of AD were the structure changes of hippocampus, brain volume change and the cerebral white matter lesions,etc. The cerebral white matter lesions is determined as the new pathological changes of AD, so the correlation with the changes of cognitive function and executive function has been proved in clinic. But because of the limit of research means, the relationship between cerebral white matter lesions and the changes of neuropsychological function has not been proved. Further research on the cerebral of white matter lesions for AD has an important impact on patients, which could help us to understand the pathological features of AD better. ObjectiveThis project aims to study the influence of cerebral white matter lesions on the changes of cognitive function and executive function to provide the reference for the diagnosis of AD. Methods(1) 80 patients with AD were screened as the study group and 60 patients without AD were selected as the control group. The cerebral white matter lesions was detected by the FLAIR sequence of MRI, and detected the WMLs, PVWMLs and DWMLs related with cerebral white matter lesions. The cognitive function and executive function were detected by ADAS-Cog、MMSE and DCT. Compared the difference of WMLs, PVWMLs and DWMLs between control group and study group, and research on the relationship between WMLs, PVWMLs and DWMLs with the cerebral white matter lesions.(2) 25 cases of the AD patients were worked as the study group A, 25 patients with mild cognitive impairment were worked as the study group B, and 25 cases of healthy elderly were used as the control group.Use DTI to detect the parameters of cerebral white matter lesions in different brain regions,and compare the differences between all of the groups. ADAS-Cog and MMSE were used to assess the cognitive function of all about the patients,and then the relationship between the cognitive function with the parameters of cerebral white matter lesions was studied.(3) 30 cases patients of AD were used as the study group, and 30 cases healthy elderly were used as the control group. DTI was used to detect the parameters of the lesions of frontal white matter, and FAB was used to assess the executive function of all about the patients. The difference of FAB score and the image parameters were compared,and the relationship between FAB scores with image parameter was studied. Results(1) The score of MMSE,ADAS-Cog and DCT of study group were different from that of control group(P<0.05), and the AD patients jointed with hypertension has a difference with the patients with single AD(P<0.05), but the difference of PVWMLs and DWMLs has no statistical difference(P>0.05). The score of WMLs has a negative correlation with the score of DCT and MMSE, has a positive correlation with ADAS-Cog.(2) The scores of MMSE and ADAS-Cog of A study group and B group were higher than those of control group, and the difference had a statistical significant(P<0.05),and there had a different between A study group and B study group(P<0.05). The FA value of frontal lobe, temporal lobe, parietal lobe of A study group had a difference with that of control group(P<0.05), the FA value of parietal lobe had a difference with control group(P<0.05). The MD value of frontal lobe and parietal lobe had difference with control group(P<0.05), and MD value of all regions had no difference with control group(P>0.05). The FA value and MMSE value of parietal lobe, temporal lobe had a correlation with the MMSE value, and the MD value of frontal lobe, parietal lobe, corpus callosum had a correlation with the score of MMSE. The MD value of parietal lobe, corpus callosum had a correlation with the word memory score, and the FA value of temporal lobe, parietal lobe had a correlation with word memory. The MD value of parietal lobe, corpus callosum had a correlation with the score of word recognition, the FA value of Temporal lobe, parietal lobe, splenium of corpus callosum had correlation with the score of word recognition.(3) The score of FAB of all patients and the FA value, MD value of frontal white matter of study group had a difference with control group(P<0.05), and there had a positive correlation between FA value and FAB value. ConclusionsThe matter damage of AD was region-selective, and the cerebral white matter damage in parietal lobe, temporal lobe, splenium of corpus callosum had a correlation with the recession of executive function. The FLAIR sequence of MRI and DTI could provide a quantitative detection for white matter lesions,could provide some help for the diagnosis of AD. |
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