临床研究

脑室周围白质损伤患者执行功能损害与日常生活活动能力的相关性

  • 王金芳 ,
  • 王万铭 ,
  • 陈红燕 ,
  • 叶娜 ,
  • 马艳玲 ,
  • 张玉梅
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  • 1.首都医科大学附属北京天坛医院神经病学中心血管神经病学科,国家神经系统疾病临床医学研究中心,北京脑重大疾病研究院脑卒中研究所,脑血管病转化医学北京市重点实验室,北京市 100050;
    2.长江航运总医院,武汉脑科医院神经内科,湖北武汉市 453100;
    3.首都医科大学附属北京天坛医院影像科,北京市 100050
王金芳(1984-),女,汉族,河南卫辉市人,博士研究生,主治医师,主要研究方向:脑血管病与认知功能障碍。

收稿日期: 2018-03-09

  网络出版日期: 2018-10-30

基金资助

1.国家自然科学基金项目(No. 81371201); 2.首都医科大学基础与临床合作重点项目(No. 16JL03); 3.北京市医院管理局临床医学发展专项经费资助(No. ZYLX201836); 4.湖北省卫生计生委科研项目(No. WJ2017F057; No. WJ2017M208)

Correlation between Executive Function and Activities of Daily Living for Patients with Periventricular White Matter Lesions

  • WANG Jin-fang ,
  • WANG Wan-ming ,
  • CHEN Hong-yan ,
  • YE Na ,
  • MA Yan-ling ,
  • ZHANG Yu-mei
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  • 1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100050, China;
    2. Department of Neurology, General Hospital of The Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, Hubei 453100, China;
    3. Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

Received date: 2018-03-09

  Online published: 2018-10-30

Supported by

National Natural Science Foundation of China (No. 81371201), Capital Medical University Research Project for Basic and Clinical Cooperation (Key) (No. 16JL03), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX201836) and Hubei Health and Family Planning Committee Research Project (No. WJ2017F057; No. WJ2017M208)

摘要

目的 探讨脑室周围白质损伤(PWMLs)患者执行功能损害与日常生活活动能力之间的关系。方法 2016年1月至2017年1月,PWMLs患者及正常对照者各35例,采用执行功能评估量表和日常生活活动能力量表(ADL)进行评估,并分析两者之间关系。结果 与正常对照组比较,PWMLs组简易精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)评分显著降低(t>13.726, P<0.001),交替连线测验时间和Stroop色词检验时间显著延长(t>6.817, P<0.001),语言流畅性测验评分降低(t=6.891, P=0.013),数字符号转换评分无显著性差异(t=3.372, P=0.072)。PWMLs组ADL评分较正常对照组显著增高(t=76.413, P<0.001)。PWMLs组执行功能Z分与ADL评分呈正相关(r=0.438, P=0.008)。结论 PWMLs患者存在执行功能损害及日常生活活动能力下降,其日常生活活动能力下降与执行功能损害的严重程度相关。

本文引用格式

王金芳 , 王万铭 , 陈红燕 , 叶娜 , 马艳玲 , 张玉梅 . 脑室周围白质损伤患者执行功能损害与日常生活活动能力的相关性[J]. 中国康复理论与实践, 2018 , 24(10) : 1182 -1186 . DOI: 10.3969/j.issn.1006-9771.2018.10.012

Abstract

Objective To study the relationship between executive function and activities of daily living for patients with periventricular white matter lesions (PWMLs). Methods From January, 2016 to January, 2017, 35 PWMLs patients and 35 normal controls were collected. Their executive function and activities of daily living were assessed with neuropsychological tests and Activities of Daily Living Scale (ADL).Results Compared with the normal control group, the scores of Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) significantly decreased (t>13.726, P<0.001), the times of Trail-Making Test and Stroop Colour Word Test significantly lengthened, the Verbal Fluency Test score decreased (t=6.891, P=0.013) and the Digit-Symbol Substitution Test score did not improve (t=3.372, P=0.072) in PWMLs group. The Z score of executive function was positively correlated with ADL score (r=0.438, P=0.008).Conclusion The executive function and activities of daily living are impaired in PWMLs patients, and their activities of daily living is related to the severity of the executive function impairment.

参考文献

[1] Hachinski VC, Potter P, Merskey H.Leukoaraiosis[J]. Arch Neurol, 1987, 44(1): 21-23.
[2] Ding X, Wu J, Zhou Z, et al.Specific locations within the white matter and cortex are in the cogitive impairments associated with periventricular white matter lesions (PWMLs)[J]. Behav Brain Res, 2015, 8(1): 9-18.
[3] Wang S, Yuan J, Guo X, et al.Neurochemical correlates of cognitive dysfunction in patients with leukoaraiosis: a proton magnetic resonance spectroscopy study[J]. Neurol Res, 2012, 34(10): 989-997.
[4] Paradise M, Seruqa A, Craword JD, et al.The relationship of cerebral microbleeds to cognition and incident dementia in non-demented older individuals[J]. Brain Imaging Behav, 2018, 5(25): 18-23.
[5] Gautam P, Narr KL, Kan EC, et al.Effects of prenatal alcohol exposure on the development of white matter volume and change in executive function[J]. Neuroimage Clin, 2014, 5(1): 19-27.
[6] Bos D, Wolters FJ, Darweesh SKL, et al. Cerebral small vessel disease and the risk of dementia: a systematic review meta-analysis of population-based evidence [J]. Alzheimers Dement, 2018. pii: S1552-5260(18)30129-8
[7] Zhao L, Wong A, Luo Y, et al.The additional contribution of white matter hyperintensity location to post-stroke cognitive impairment: insights from a multiple-lesion symptom mapping study[J]. Front Neurosci, 2018, 12:29.
[8] Rizvi B, Narkhede A, Last BS, et al.The effect of white matter Hyperintensity on cognition is mediated by cortical atrophy[J]. Neurobiol Aging, 2018, 4(64): 25-32.
[9] Kim KW, Macfall JR, Payne ME.Classification of white matter lesions on magnetic resonance imaging in elderly persons[J]. Biol Psychiatry, 2008, 64(4): 273-280.
[10] 郭起浩,孙一忞,袁晶,等. 8种执行功能测验在上海社区老年人中的应用[J]. 中华行为医学与脑科学杂志, 2007, 16(7): 628-631.
[11] Schmidt R, Ropele S, Ferro J, et al.Diffusion-weighted imaging and cognition in the leukoariosis and disability in the elderly study[J]. Stroke, 2010, 41(5): e402-e408.
[12] Reitan RM.The relation of the trail making test to organic brain damage[J]. J Consult Psychol, 1955, 19(5): 393-394.
[13] Sheridan LK, Fitzgerald HE, Adams KM, et al.Normative symbol digit modalities test performance in a community-based sample[J]. Arch Clin Neuropsychol, 2006, 21(1): 23-28.
[14] Batchelor J, Harvey AG, Bryant RA.Stroop Colour Word Test as a measure of attentional deficit following mild head injury[J]. Clin Neuropsychol, 1995, 9(2): 180-186.
[15] Casalscoll M, Sánchezbenavides G, Quintana M, et al.Spanish normative studies in young adults (NEURONORMA young adults project): norms for verbal fluency tests[J]. Neurología, 2013, 28(1): 33-40.
[16] Ratiu I, Virden TB, Baylow H, et al.Executive function and quality of life in individuals with Marfan syndrome[J]. Qual Life Res, 2018, 27(8): 2057-2065.
[17] Manly T, Hawkins K, Evans J, et al.Rehabilitation of executive function: facilitation of effective goal management on complex tasks using periodic auditory alerts[J]. Neuropsychologia, 2002, 40(3): 271.
[18] Best MW, Gale D, Tran T, et al. Brief executive function training for individuals with severe mental illness: Effects on EEG synchronization and executive functioning [J]. Schizophr Res, 2017. pii: S0920-9964(17)30528-5.
[19] Murray ME, Senjem ML, Petersen RC, et al.Functional impact of white matter hyperintensities in cognitively normal elderly[J]. Arch Neurol, 2010, 67(11):1379-1385.
[20] de Groot JC, de Leeuw FE, Oudkerk M, et al. Cerebral white matter lesions and subjective cognitive dysfunction: the Rotterdam Scan Study[J]. Neurology, 2001, 56(11): 1539-1545.
[21] Lamar M, Price CD, Penney D, et al.Alterations in working memory as a function of leukoaraiosis in dementia[J]. Neuropsychologia, 2007, 45(2): 245.
[22] Langdon C, Blacker D. Dysphagia in stroke: a new solution [J]. Stroke Res Treat, 2010, pii: 570403.
[23] Griffanti L, Jenkinson M, Suri S, et al.Classification and characterization of periventricular and deep white matterhyperintensities on MRI: A study in older adults[J]. Neruoimage, 2018, 4(15): 174-181.
[24] 孟琛,汤哲. 社区老年人认知功能变化及其预后的五年前瞻性研究[J]. 中华神经科杂志, 2000, 33(3): 138-140.
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