本文關(guān)鍵詞： 輕度認(rèn)知功能損害 神經(jīng)心理學(xué) 磁共振波譜　出處：《安徽醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的采用神經(jīng)心理學(xué)量表，探討不同亞型輕度認(rèn)知功能損害（MCI）的神經(jīng)心理學(xué)特征；應(yīng)用氫質(zhì)子磁共振波譜技術(shù)（1H MRS），揭示不同亞型MCI顱內(nèi)代謝改變的特點(diǎn)，以及1H MRS代謝指標(biāo)與認(rèn)知損害之間的關(guān)系，進(jìn)一步探討1H MRS在不同亞型MCI鑒別診斷中的意義。 方法采用一系列神經(jīng)心理學(xué)量表檢查，包括簡(jiǎn)易智能狀態(tài)量表（MMSE）、劍橋老年認(rèn)知檢查量表中文版（CAMCOG-C）、老年抑郁自評(píng)量表（GDS）等，比較遺忘型MCI（A-MCI）、血管型MCI(V-MCI)及帕金森病型MCI（PD-MCI）的神經(jīng)心理學(xué)特征。對(duì)14例A-MCI、12例V-MCI及17例認(rèn)知功能正常老年人進(jìn)行單體素1H MRS檢查，磁共振設(shè)備選擇GE公司的Signa3.0T超導(dǎo)磁共振，興趣區(qū)在優(yōu)勢(shì)半球的額葉、基底節(jié)區(qū)及海馬，通過對(duì)各興趣區(qū)波譜信號(hào)的采集，最終系統(tǒng)自動(dòng)以Cr為內(nèi)參給出各代謝指標(biāo)的比值，包括NAA/Cr、Cho/Cr及MI/Cr。比較A-MCI與V-MCI患者1H MRS代謝指標(biāo)改變的不同及其代謝指標(biāo)與認(rèn)知之間的相關(guān)性。 結(jié)果（1）研究對(duì)象各組年齡、性別及受教育程度方面均無(wú)統(tǒng)計(jì)學(xué)意義，A-MCI與V-MCI組高血壓患病率顯著增高。（2）A-MCI、V-MCI及PD-MCI均在多個(gè)認(rèn)知區(qū)域受損，其中A-MCI組以近記憶、學(xué)習(xí)記憶及計(jì)算受損突出，V-MCI組運(yùn)用功能受損明顯，PD-MCI的認(rèn)知損害最為廣泛，除近記憶、學(xué)習(xí)記憶受損外，遠(yuǎn)記憶功能及運(yùn)用功能均顯著受損，，與A-MCI及V-MCI組比較均有統(tǒng)計(jì)學(xué)意義。A-MCI組GDS評(píng)分較正常對(duì)照組顯著增高。（3）V-MCI組左側(cè)額葉NAA/Cr比值較對(duì)照組及A-MCI組顯著降低，NAA/Cr降低水平與CAMCOG-C總體得分、定向、語(yǔ)言理解及運(yùn)用均呈顯著正相關(guān)。A-MCI組在左側(cè)海馬NAA/Cr比值顯著降低，與V-MCI組及對(duì)照組相比均有統(tǒng)計(jì)學(xué)意義，與該組的近記憶得分顯著正相關(guān)。三組在左側(cè)基底區(qū)各項(xiàng)代謝指標(biāo)均無(wú)顯著改變。 結(jié)論（1）A-MCI、V-MCI與PD-MCI認(rèn)知損害均為多區(qū)域性，A-MCI主要表現(xiàn)為記憶損害，V-MCI以執(zhí)行功能損害為主，PD-MCI記憶及執(zhí)行功能均受損。A-MCI較其他亞型更易出現(xiàn)抑郁傾向。（2）1H MRS可以將A-MCI或V-MCI與正常老年人相鑒別，海馬與額葉的NAA/Cr比值能分別較好的反映A-MCI與V-MCI認(rèn)知損害的程度。1H MRS可能是鑒別A-MCI與V-MCI的有效工具之一。
[Abstract]:Objective to explore the neuropsychological characteristics of mild cognitive impairment (MCI) in different subtypes of MCI by using neuropsychological scale, and to reveal the characteristics of intracranial metabolic changes in different subtypes of MCI by using 1H Mr spectroscopy. And the relationship between 1H MRS metabolic index and cognitive impairment, and the significance of 1H MRS in differential diagnosis of different MCI subtypes. Methods A series of neuropsychological scales were used, including simple Mental State scale (MMSEN), Cambridge Cognitive scale for the elderly (CAMCOG-CU), Self-Rating Depression scale for the elderly (GDSs) and so on. To compare the neuropsychological characteristics of amnesia type MCI A-MCI, vascular type MCIV MCI and Parkinson's disease MCII PD-MCI. Monomers 1H MRS were examined in 14 patients with A-MCI, 12 patients with V-MCI and 17 elderly patients with cognitive function. The magnetic resonance equipment was GE Signa3.0T superconducting magnetic resonance (Mr). The region of interest is in the frontal lobe, basal ganglia and hippocampus of the dominant hemispheres. By collecting the spectral signals of each region of interest, the system automatically uses Cr as the internal reference to give the ratio of each metabolic index. The changes of 1H MRS metabolic indexes in A-MCI and V-MCI patients were compared, and the correlation between metabolic indexes and cognition was compared between A-MCI patients and V-MCI patients. Results (1) there was no significant difference in age, sex and education level between A-MCI group and V-MCI group. The prevalence of hypertension in A-MCI group and V-MCI group was significantly higher than that in A-MCI group. Both V-MCI and PD-MCI were damaged in multiple cognitive regions, among which A-MCI group had near memory. In the V-MCI group, the cognitive impairment of PD-MCI was the most extensive. In addition to the impairment of near memory and learning memory, the function of distant memory and application were all significantly impaired. Compared with A-MCI group and V-MCI group, the GDS score of A-MCI group was significantly higher than that of normal control group. The NAA/Cr ratio of left frontal lobe in A-MCI group was significantly lower than that in control group and A-MCI group. The ratio of NAA/Cr in left hippocampus was significantly decreased in A-MCI group compared with V-MCI group and control group. There was no significant change in all metabolic indexes in the left basal area in the three groups. Conclusion both A-MCICI and PD-MCI cognitive impairment are multi-regional. The main manifestation of A-MCI is memory impairment. Both memory and executive function are impaired. A-MCI is more likely to develop depression tendency than other subtypes. A-MCI or V-MCI can be associated with A-MCI or V-MCI. The normal old people are distinguished from each other. The ratio of NAA/Cr in hippocampus to frontal lobe can reflect the degree of cognitive impairment between A-MCI and V-MCI. 1H MRS may be one of the effective tools to distinguish A-MCI from V-MCI.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R749.1

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相關(guān)期刊論文 前2條

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本文編號(hào)：1544421