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在神经退行性疾病中,白质过强度和神经精神病症状
Shigeki Katakami1, Hideki Kanemoto1,2, Daiki Taomoto1
1Department of Psychiatry, The University of Osaka Graduate School of Medicine, Suita, Osaka, Japan.
Journal of clinical neurology (Seoul, Korea)
|March 3, 2026
概括
白质超强度 (WMHs) 与轻度认知障碍中的神经精神症状 (NPS) 有关,但与阿尔茨海默氏症痴呆症或勒维体痴呆症无关. 这表明WMHs在认知衰退的早期,前期阶段对NPS的影响更大.
科学领域:
- 神经成像是一种神经成像.
- 神经学 神经学
- 认知科学 认知科学
背景情况:
- 神经精神症状 (NPS) 在痴呆和轻度认知障碍 (MCI) 中很常见.
- 白质过强度 (WMHs) 和NPS之间的关系被不一致地报道.
- 这项研究调查了阿尔茨海默病痴呆症 (ADD),勒维体痴呆症 (DLB) 和大脑失忆性MCI (aMCI) 中WMH与NPS的关联.
研究的目的:
- 检查在ADD,DLB和aMCI中WMH和NPS之间的项目级协会.
- 为了确定WMH与NPS的关联是否在这些神经退行性疾病中存在差异.
- 探索WMHs对NPS的潜在阶段依赖的影响.
主要方法:
- 在523名患者 (276名ADD,67名DLB,180名aMCI) 的多中心追溯研究中.
- 使用BAAD软件分析的MRI扫描 (T1加权,T2-FLAIR) 来量化WMH体积 (WMHV) 和灰质体积 (GMV),正常化为总内体积 (TIV).
- 通过神经精神科目录评估NPS;多重回归分析对共变量进行了调整.
主要成果:
- 在aMCI中,较高的WMHV/TIV与抑郁症,冷漠,无抑制以及反向与妄想相关.
- 在ADD或DLB组中没有发现WMH与NPS的显著关联.
- 灰质体积显示了与妄想 (ADD) 和幻觉 (DLB) 的差异关联.
结论:
- 在aMCI中存在WMH与NPS的关联,但在ADD或DLB中没有,这表明阶段依赖的效应.
- WMHs可能主要在预发性阶段影响NPS,后期痴呆阶段的神经退行可能会掩盖其影响.
- 了解WMH机制对于开发有针对性的干预措施至关重要.
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