RESULTS: A total of 124 participants with Alzheimer disease, cerebrovascular disease, or a mix Alzheimer\'s and cerebrovascular diseases and 55 controlparticipants underwent magnetic resonance imaging and neuropsychological testing. BBB permeability was measured with dynamic contrast-enhanced magnetic resonance imaging and white matter injury was measured using a quantitative diffusion-tensor imaging marker of white matter injury. Structural equation modeling was used to examine the relationships between BBB permeability, vascular risk burden, white matter injury, and cognitive functioning. Vascular risk burden predicted BBB permeability (r=0.24, P<0.05) and white matter injury (r=0.38, P<0.001). BBB permeability predicted increased white matter injury (r=0.34, P<0.001) and increased white matter injury predicted lower cognitive functioning (r=-0.51, P<0.001).
CONCLUSIONS: The study provides empirical support for a vascular contribution to white matter injury and cognitive impairment, directly or indirectly via BBB permeability. This highlights the importance of targeting modifiable vascular risk factors to help mitigate future cognitive decline.
结果:共有124名患有阿尔茨海默病的参与者,脑血管疾病,或混合的阿尔茨海默氏症和脑血管疾病和55名对照参与者进行了磁共振成像和神经心理学测试。使用动态对比增强磁共振成像测量BBB通透性,并使用白质损伤的定量扩散张量成像标记测量白质损伤。结构方程模型用于检验BBB渗透率之间的关系,血管风险负担,白质损伤,和认知功能。血管风险负荷可预测BBB通透性(r=0.24,P<0.05)和白质损伤(r=0.38,P<0.001)。BBB通透性可预测白质损伤增加(r=0.34,P<0.001),白质损伤增加可预测认知功能降低(r=-0.51,P<0.001)。
结论:该研究为血管对白质损伤和认知障碍的贡献提供了经验支持,直接或间接通过BBB通透性。这突出了针对可改变的血管危险因素的重要性,以帮助减轻未来的认知能力下降。