已发表论文

对于老年高血压患者,认知障碍与从磁共振扩散加权成像获得表观扩散系数值之间的关系

 

Authors Zhao YW, Wu G, Shi HM, Xia ZJ, Sun T

Published Date July 2014 Volume 2014:9 Pages 1223—1231

DOI http://dx.doi.org/10.2147/CIA.S63567

Received 5 March 2014, Accepted 8 May 2014, Published 28 July 2014

Background: The purpose of this study was to determine a new method for the early diagnosis and assessment of mild cognitive impairment in elderly individuals with hypertension. Elderly hypertensive patients with cognitive impairment were assessed by the Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating Assessment (CDR). Cognitive results were compared to apparent diffusion coefficient (ADC) values from magnetic resonance-diffusion weighted imaging.
Methods: A total of 191 patients were categorized into four groups: a control group (normal cognition and no hypertension; n=20); a normal group (hypertension and normal cognition; n=33); an mild cognitive impairment group (n=80); and a vascular dementia group (n=58). The MoCA and CDR tests were used to determine cognition. ADC values in eight brain regions were calculated with magnetic resonance-diffusion weighted imaging. Other characteristics were evaluated, eg, blood pressure, MoCA, and CDR scores, and the comparisons of the four groups were made.
Results: The MoCA and CDR scores differed among the four groups (<0.001). Systolic and diastolic blood pressure values increased as cognitive function declined (<0.001). Cognitive function declined as ADC values increased, and they differed between elderly people with and without hypertension (<0.001). Among elderly hypertensive participants, ADC values were significantly increased in the cortex and hippocampus.
Conclusion: The MoCA and CDR tests were sufficiently sensitive to evaluate cognition. Blood pressure was closely related to cognition, as well as to functional and structural changes in the brain. These alterations were evidenced through changes in the ADC values and were most obvious in the cortex and hippocampus. Greater cognitive decline was observed in elderly participants with hypertension compared to those without. As hypertensive stage increased, greater ADC values were observed.
Keywords: Clinical Dementia Rating Assessment, hypertension, mild cognitive impairment, Montreal Cognitive Assessment