Serebral Mikrokanama Yükü ve Yerleşiminin Kognitif Disfonksiyon ile İlişkisi

Cognitive Dysfunction in Relation to Topography and Burden of Cerebral Microbleeds

Mehmet Akif TOPÇUOĞLU, Ethem Murat ARSAVA, Kader KARLI OĞUZ, Esen SAKA, Rahşan GÖÇMEN, Gülseren BÜYÜKŞERBETÇİ

Özet

Amaç: Manyetik rezonans (MR) görüntülemede diğer açılardan asemptomatik serebral beyaz cevher lezyonu (SBL) saptanan yaşlılarda bulunan serebral mikrokanamaların (SMK) kognitif fonksiyonlara olan etkisi yeterince ayrılıp dokümante edilmiş değildir. Yöntem: Serebral atrofi, SMK ve SBL’nin MR parametreleri ile kognisyonun global ve ana eksenleri (dikkat, yürütücü, hafıza, görseluzaysal ve lisan) arasındaki bağlantı tesadüfen SMK saptanan yaşı elliden büyük 85 hastada çalışıldı. Tanı almış nörodejeneratif ve nörovasküler hastalığı olmayan bu çalışma popülasyonu, bir yıl süresince T2*-gradient eko sekansı ile beyin MR çekilmiş olan 2562 olgu arasından geriye dönük olarak tespit edilip muayeneye çağrıldı.

Abstract

Hacettepe University Medical School Hospital, Department of Radiology, Ankara, TurkeyIntroduction: Contribution of cerebral microbleeds (CMBs) on cognitivedysfunctions in elderly patients with otherwise asymptomatic whitematter lesions (WMLs) is not well-documented.Methods: MRI parameters of cerebral atrophy, CMBs and WMLs wereherein analyzed in relation to global and main domains (attention,executive, memory, visuospatial, language) of cognitive function. Eightyfivepatients older than 50, without neurodegenerative/cerebrovasculardisease, but had CMBs were recruited from 2562 with T2*-gradient-echoMR imaging during one-year period.Results: Global cognition, evaluated by mini-mental status examination(MMSE), was impaired (score ≤24) in 42%. In contrast to CMBs load,WML burden and temporal atrophy were significantly higher in caseswith MMSE≤24. Cholinergic Pathways HyperIntensities Scale (CHIPS)was positively correlated with global cognitive dysfunction but its CMBcounterpart, Cholinergic Pathways Bleeding Scale described herein, wasnot. However, burden of CMBs in thalamic/cortical regions predictedlanguage dysfunction.Conclusion: Cognitive dysfunction associated with CMBs may bedependent on their distribution rather than their absolute number.