주관적 기억감퇴를 가진 노인에서 백질 변화와 인지기능 장애의 관련성 = Relationship between White Matter Changes and Cognitive Dysfunction in the Elderly with Subjective Memory Complaint

다국어 초록 (Multilingual Abstract)

Objectives The purpose of this study is to evaluate the relationship between the severity of white matter changes (WMC), risk factors and cognitive domains, including executive function profiles. Method Forty nine subjects over 55 years with subjective memory complaints were assessed with MRI and neuropsychological tests. The WMC were assessed by MRI T2-FLAIR images and divided into 3 groups of mild vs. moderate vs. severe and 2 groups of mild-moderate vs. severe by using Mantyla's criteria and Fazeka's criteria. The risk factors were examined in hypertension, heart disease history and chemistry Lab. Medical conditions which affect to cognitive dysfunction and definite dementia were also excluded. Results Comparing 3 groups, hypertension was identified as a risk factor of the WMC. Comparing 2 groups, total cholesterol and LDL were identified for as the risk factor of WMC. The severity of WMC was significantly associated with cognitive disturbances and their main effect on cognition was working memory and inhibition. Conclusion The risk factors of the WMC in the elderly were hypertension, hyperlipidemia. The severity of WMC appears to be associated with executive dysfunction in the elderly.

참고문헌 (Reference)

1 Román GC, "Vascular dementia: diagnostic criteria for research studies" 250-260, 1993

2 Erkinjuntti T, "Vascular cognitive deterioration and stroke" 24 (24): 189-194, 2007

3 Kalaria RN, "Towards defining the neuropathological substrates of vascular dementia" 226 : 75-80, 2004

4 Tobiansky R, "The Gospel Oak Study stage IV: the clinical relevance of subjective memory impairment in older people" 25 : 779-786, 1995

5 Iliffe S, "Subjective memory problems" 340 (340): 2010

6 Gagnon M, "Self-reported memory complaints and memory performance in elderly French community residents: results of the PAQUID Research Program" 13 : 145-154, 1994

7 Green RC, "Risk of dementia among white and African American relatives of patients with Alzheimer disease" 287 : 329-336, 2002

8 Garde E, "Relation between age-related decline in intelligence and cerebral whitematter hyperintensities in healthy octogenarians: a longitudinal study" 356 : 628-634, 2000

9 Liao D, "Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control. The ARIC Study. Atherosclerosis Risk in Communities Study" 27 : 2262-2270, 1996

10 De Groot JC, "Periventricular cerebral white matter lesions predict rate of cognitive decline" 52 : 335-341, 2002

11 Pantoni L, "Pathogenesis of leukoaraiosis: a review" 28 : 652-659, 1997

12 Tatemichi TK, "Paramedian thalamopeduncular infarction: clinical syndromes and magnetic resonance imaging" 32 : 162-171, 1992

13 Kang Y, "Parallel short form of the Korean-Boston Naming Test(K-BNT)" 18 : 144-150, 2000

14 Sabri O, "Neuropsychological impairment correlates with hypoperfusion and hypometabolism but not with severity of white matter lesions on MRI in patients with cerebral microangiopathy" 30 : 556-566, 1999

15 Boone KB, "Neuropsychological correlates of white-matter lesions in healthy elderly subjects. A threshold effect" 49 : 549-554, 1992

16 Mendez MF, "Neurobehavioral changes associated with caudate lesions" 39 : 349-354, 1989

17 Jonker C, "Memory complaints and memory impairment in older individuals" 44 : 44-49, 1996

18 O’Connor DW, "Memory complaints and impairment in normal, depressed, and demented elderly persons identified in a community survey" 47 : 224-227, 1990

19 Bassett SS, "Memory complaint, memory performance, and psychiatric diagnosis: a community study" 6 : 105-111, 1993

20 Blazer DG, "Memory complaint as a predictor of cognitive decline: a comparison of African American and White elders" 9 : 171-184, 1997

21 Mäntylä R, "Magnetic resonance imaging white matter hyperintensities and mechanism of ischemic stroke" 30 : 2053-2058, 1999

22 Schmidt R, "Magnetic resonance imaging cerebral abnormalities and neuropsychologic test performance in elderly hypertensive subjects. A case-control study" 52 : 905-910, 1995

23 Wahlund LO, "MRI in successful aging, a 5-year follow-up study from the eighth to ninth decade of life" 14 : 601-608, 1996

24 Fazekas F, "MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging" 149 : 351-356, 1987

25 Longstreth WT Jr, "Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study" 55 : 1217-1225, 1998

26 Awad IA, "Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. II. Postmortem pathological correlations" 17 : 1090-1097, 1986

27 Vermeer SE, "Homocysteine, silent brain infarcts, and white matter lesions: The Rotterdam Scan Study" 51 : 285-289, 2002

28 Kramer JH, "Executive dysfunction in subcortical ischaemic vascular disease" 72 : 217-220, 2002

29 Matsui T, "Elevated plasma homocysteine levels and risk of silent brain infarction in elderly people" 32 : 1116-1119, 2001

30 Reed BR, "Effects of white matter lesions and lacunes on cortical function" 61 : 1545-1550, 2004

31 Wen HM, "Effect of white matter changes on cognitive impairment in patients with lacunar infarcts" 35 : 1826-1830, 2004

32 Erkinjuntti T, "Do white matter changes on MRI and CT differentiate vascular dementia from Alzheimer’s disease" 50 : 37-42, 1987

33 Wolf H, "Do white matter changes contribute to the subsequent development of dementia in patients with mild cognitive impairment? A longitudinal study" 15 : 803-812, 2000

34 Kim TY, "Development of the Korean stroop test and study of the validity and the reliability." 8 : 233-240, 2004

35 Longstreth WT Jr, "Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study" 27 : 1274-1282, 1996

36 Breteler MM, "Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study" 44 : 1246-1252, 1994

37 Bots ML, "Cerebral white matter lesions and atherosclerosis in the Rotterdam Study" 341 : 1232-1237, 1993

38 Prins ND, "Cerebral small-vessel disease and decline in information processing speed, executive function and memory" 128 : 2034-2041, 2005

39 Snowdon DA, "Brain infarction and the clinical expression of Alzheimer disease" 277 : 813-817, 1997

40 Kang Y, "A validity study on the Korean Mini- Mental State Examination (K-MMSE) in dementia patients" 15 : 300-308, 1997