脑萎缩伴随精神障碍的脑CT特征与患者认知功能的相关性

摘要/Abstract

摘要： 目的探讨与分析脑萎缩伴随精神障碍的脑CT特征及其与患者认知功能的相关性。方法选择2023年2月—2024年10月在阿克苏地区第四人民医院诊治的脑萎缩伴随精神障碍的107例患者作为病例组,同期选择健康体检者107名作为对照组。所有人群都给予脑常规CT检查与CT灌注（CTP）成像检查,记录脑CT特征与灌注参数。采用蒙特利尔认知评估量表（MoCA）对所有人群进行认知功能评定与相关性分析。结果病例组的皮质萎缩、脑室扩大、脑沟增宽等脑CT特征占比高于对照组,差异有统计学意义（P<0.05）。病例组的平均通过时间（MTT）、达峰时间（TTP）、脑血流量（CBF）比对照组高,差异有统计学意义（P<0.05）;病例组的脑血容量（CBV）低于对照组,差异有统计学意义（P<0.05）。病例组的视觉空间、语言、注意力、抽象思维、执行功能、总评分等认知功能评分低于对照组,差异有统计学意义（P<0.05）;病例组的认知功能障碍发生率高于对照组,差异有统计学意义（P<0.05）。Spearsman相关法分析显示,皮质萎缩、脑室扩大、脑沟增宽、TTP、MTT、CBF、CBV与认知功能总评分相关,差异有统计学意义（P<0.05）。结论脑萎缩伴随精神障碍多伴有脑CT特征、灌注参数、认知功能异常,脑萎缩伴随精神障碍的脑CT特征与患者认知功能存在相关性。

关键词: 脑萎缩, 精神障碍, CT灌注成像, 皮质萎缩, 脑室扩大, 认知功能

中图分类号:

R749.1

韩宗保, 吴恩. 脑萎缩伴随精神障碍的脑CT特征与患者认知功能的相关性[J]. 中华养生保健, 2025, 43(10): 181-185.

参考文献

[1] 杨雪,李繁菊,谢沁芳,等.多发性硬化脑萎缩预测残疾和认知障碍的研究进展[J].神经损伤与功能重建,2025,20(1):45-48.
[2] 刘璇,侯丽亚,万东君,等.儿童及青年患者单侧脑萎缩相关疾病临床特征及发病机制的研究进展[J].临床神经病学杂志,2022,35(6):465-469.
[3] BLINKOUSKAYA Y,WEICKENMEIER J.Brain shape changes associated with cerebral atrophy in healthy aging and Alzheimer's disease[J].Front Mech Eng,2021,7:705653.
[4] LAGANÀ V,BRUNO F,ALTOMARI N,et al.Neuropsychiatric or behavioral and psychological symptoms of dementia (BPSD):focus on prevalence and natural history in Alzheimer's disease and frontotemporal dementia[J].Front Neurol,2022,13:832199.
[5] ZACKOVA L,JANI M,BRAZDIL M,et al.Cognitive impairment and depression:meta-analysis of structural magnetic resonance imaging studies[J].NeuroImage-Clin,2021,32:102830.
[6] LÖVBLAD K O,WANKE I,BOTTA D,et al.Brain Health in Neuroradiology[J].Clinical and Translational Neuroscience,2024,9(1):1.
[7] FAN D,LI H,CHEN D,et al.Chronic hypoperfusion due to intracranial large artery stenosis is not associated with cerebral β-amyloid deposition and brain atrophy[J].Chinese Med J-Peking,2022,135(5):591-597.
[8] RODRÍGUEZ-VÁZQUEZ A,LAREDO C,REYES L,et al.Computed tomography perfusion as an early predictor of malignant cerebral infarction[J].European Stroke Journal(ESJ),2024:23969873241260965.
[9] 2030脑与类脑计划变性病痴呆多模影像诊断标准及分子影像技术研究课题组,上海市衰老与退行性疾病学会衰老与认知障碍分会,王刚,等.痴呆及相关认知障碍的神经影像学诊断专家共识(2023年版)[J].诊断学理论与实践,2024,23(1):30-39.
[10] AMERICAN PSYCHIATRIC ASSOCIATION D,AMERICAN PSYCHIATRIC ASSOCIATION D S.Diagnostic and statistical manual of mental disorders:DSM-5[M].Washington,DC:American psychiatric association,2013.
[11] Ciesielska N,Sokołowski R,Mazur E,et al.Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis[J].Psychiatr Pol,2016,50(5):1039-1052.
[12] PELOWSKI M,SPEE B T M,ARATO J,et al.Can we really ‘read’art to see the changing brain? A review and empirical assessment of clinical case reports and published artworks for systematic evidence of quality and style changes linked to damage or neurodegenerative disease[J].Phys Life Rev,2022,43:32-95.
[13] FRANCIS P T,PALMER A M,SNAPE M,et al.The cholinergic hypothesis of Alzheimer’s disease:a review of progress[J].J Neurol Neurosur Ps,1999,66(2):137-147.
[14] LEYANE T S,JERE S W,HOURELD N N.Oxidative stress in ageing and chronic degenerative pathologies:molecular mechanisms involved in counteracting oxidative stress and chronic inflammation[J].Int J Mol Sci,2022,23(13):7273.
[15] XIA Q,YANG X Y,SHI J B,et al.The protective A673T mutation of amyloid precursor protein (APP) in Alzheimer’s disease[J].Mol Neurobiol,2021,58(8):4038-4050.
[16] 赵富中. 脑萎缩伴随精神障碍的老年患者头颅CT诊断价值分析[J].婚育与健康,2024,30(5):37-39.
[17] 周莉萍,孙玉涛,王卓.脑部MRI联合CT在首发精神分裂症诊断中的应用价值研究[J].中国CT和MRI杂志,2023,21(5):10-12,27.
[18] 林生. 脑灌注CT成像参数预测症状性颅内动脉狭窄支架成形术预后的价值[J].现代医用影像学,2024,33(8):1422-1425.
[19] CAPASSO R,VALLONE S,SERRA N,et al.Qualitative versus automatic evaluation of CT perfusion parameters in acute posterior circulation ischaemic stroke[J].Neuroradiology,2021,63:317-330.
[20] MOKHBER N,SHARIATZADEH A,AVAN A,et al.Cerebral blood flow changes during aging process and in cognitive disorders:A review[J].The neuroradiology journal,2021,34(4):300-307.
[21] 许春燕,陈淑芬,孙云闯,等.皮质基底节综合征患者临床及影像学特点分析[J].中华神经科杂志,2022,55(6):626-633.
[22] ALZOLA P,CARNERO C,BERMEJO-PAREJA F,et al.Neuropsychological Assessment for Early Detection and Diagnosis of Dementia:Current Knowledge and New Insights[J].J Clin Med,2024,13(12):3442.
[23] LAGARDE J,OLIVIERI P,TONIETTO M,et al.Tau-PET imaging predicts cognitive decline and brain atrophy progression in early Alzheimer′s disease[J].J Neurol Neurosur Ps,2022,93(5):459-467.
[24] BONAKDARPOUR B,TAKARABE C.Brain networks,clinical manifestations,and neuroimaging of cognitive disorders:The role of computed tomography (CT),magnetic resonance imaging (MRI),positron emission tomography (PET),and other advanced neuroimaging tests[J].Clin Geriatr Med,2023,39(1):45-65.