Abstract：
BACKGROUND: Vascular mild cognitive impairment (VMCI) is a transitional condition that may evolve into Vascular Dementia(VaD). Hippocampal volume (HV) is suggested as an early marker for VaD, the role of white matter lesions (WMLs) in neurodegeneration remains debated.
OBJECTIVE: Evaluate HV and WMLs as predictive markers of VaD in VMCI patients by assessing: (i)baseline differences in HV and WMLs between converters to VaD and non-converters, (ii) predictive power of HV and WMLs for VaD, (iii) associations between HV, WMLs, and cognitive decline, (iv)the role of WMLs on HV.
METHODS: This longitudinal multicenter study included 110 VMCI subjects (mean age:74.33 ± 6.63 years, 60males/50females) from the VMCI-Tuscany Study database. Subjects underwent brain MRI and cognitive testing, with 2-year follow-up data on VaD progression. HV and WMLs were semi-automatically segmented and measured. ANCOVA assessed group differences, while linear and logistic regression models evaluated predictive power.
RESULTS: After 2 years, 32/110 VMCI patients progressed to VaD. Converting patients had lower HV(p = 0.015) and higher lesion volumes in the posterior thalamic radiation (p = 0.046), splenium of the corpus callosum (p = 0.016), cingulate gyrus (p = 0.041), and cingulum hippocampus(p = 0.038). HV alone did not fully explain progression (p = 0.059), but combined with WMLs volume, the model was significant (p = 0.035). The best prediction model (p = 0.001) included total HV (p = 0.004) and total WMLs volume of the posterior thalamic radiation (p = 0.005) and cingulate gyrus (p = 0.005), achieving 80% precision, 81% specificity, and 74% sensitivity. Lower HV were linked to poorer performance on the Rey Auditory-Verbal Learning Test delayed recall (RAVLT) and Mini Mental State Examination (MMSE).
CONCLUSIONS: HV and WMLs are significant predictors of progression from VMCI to VaD. Lower HV correlate with worse cognitive performance on RAVLT and MMSE tests.
OBJECTIVE: Evaluate HV and WMLs as predictive markers of VaD in VMCI patients by assessing: (i)baseline differences in HV and WMLs between converters to VaD and non-converters, (ii) predictive power of HV and WMLs for VaD, (iii) associations between HV, WMLs, and cognitive decline, (iv)the role of WMLs on HV.
METHODS: This longitudinal multicenter study included 110 VMCI subjects (mean age:74.33 ± 6.63 years, 60males/50females) from the VMCI-Tuscany Study database. Subjects underwent brain MRI and cognitive testing, with 2-year follow-up data on VaD progression. HV and WMLs were semi-automatically segmented and measured. ANCOVA assessed group differences, while linear and logistic regression models evaluated predictive power.
RESULTS: After 2 years, 32/110 VMCI patients progressed to VaD. Converting patients had lower HV(p = 0.015) and higher lesion volumes in the posterior thalamic radiation (p = 0.046), splenium of the corpus callosum (p = 0.016), cingulate gyrus (p = 0.041), and cingulum hippocampus(p = 0.038). HV alone did not fully explain progression (p = 0.059), but combined with WMLs volume, the model was significant (p = 0.035). The best prediction model (p = 0.001) included total HV (p = 0.004) and total WMLs volume of the posterior thalamic radiation (p = 0.005) and cingulate gyrus (p = 0.005), achieving 80% precision, 81% specificity, and 74% sensitivity. Lower HV were linked to poorer performance on the Rey Auditory-Verbal Learning Test delayed recall (RAVLT) and Mini Mental State Examination (MMSE).
CONCLUSIONS: HV and WMLs are significant predictors of progression from VMCI to VaD. Lower HV correlate with worse cognitive performance on RAVLT and MMSE tests.
摘要：
背景：血管性轻度认知障碍（VMCI）是一种过渡性疾病，可能演变成血管性痴呆（VaD）。海马体积（HV）被认为是VaD的早期标记，白质病变（WMLs）在神经变性中的作用仍存在争议。
目的：通过评估：（i）在VMCI患者中，HV和WML作为VaD的预测标志物，(Ii)HV和WML对VaD的预测能力，(iii)HV之间的关联，WMLs,和认知能力下降，(Iv)WML对HV的作用。
方法：这项纵向多中心研究包括110名VMCI受试者（平均年龄：74.33±6.63岁，60名男性/50名女性)来自VMCI-托斯卡纳研究数据库。受试者接受了脑部MRI和认知测试，关于VaD进展的2年随访数据。HV和WML被半自动分割和测量。ANCOVA评估了组间差异，而线性和逻辑回归模型评估预测能力。
结果：2年后，32/110名VMCI患者进展为VaD。转换患者在后丘脑辐射中具有较低的HV（p=0.015）和较高的病变体积（p=0.046），call体的脾（p=0.016），扣带回（p=0.041），和海马扣带（p=0.038）。单独的HV不能完全解释进展（p=0.059），但结合WMLs的体积，模型显著(p=0.035).最佳预测模型（p=0.001）包括后丘脑辐射（p=0.005）和扣带回（p=0.005）的总HV（p=0.004）和总WMLs体积，达到80%的精度，81%的特异性,74%的灵敏度。较低的HV与Rey听觉言语学习测试延迟回忆（RAVLT）和迷你精神状态检查（MMSE）的表现较差有关。
结论：HV和WML是VMCI向VaD进展的重要预测因子。在RAVLT和MMSE测试中，较低的HV与较差的认知表现相关。
目的：通过评估：（i）在VMCI患者中，HV和WML作为VaD的预测标志物，(Ii)HV和WML对VaD的预测能力，(iii)HV之间的关联，WMLs,和认知能力下降，(Iv)WML对HV的作用。
方法：这项纵向多中心研究包括110名VMCI受试者（平均年龄：74.33±6.63岁，60名男性/50名女性)来自VMCI-托斯卡纳研究数据库。受试者接受了脑部MRI和认知测试，关于VaD进展的2年随访数据。HV和WML被半自动分割和测量。ANCOVA评估了组间差异，而线性和逻辑回归模型评估预测能力。
结果：2年后，32/110名VMCI患者进展为VaD。转换患者在后丘脑辐射中具有较低的HV（p=0.015）和较高的病变体积（p=0.046），call体的脾（p=0.016），扣带回（p=0.041），和海马扣带（p=0.038）。单独的HV不能完全解释进展（p=0.059），但结合WMLs的体积，模型显著(p=0.035).最佳预测模型（p=0.001）包括后丘脑辐射（p=0.005）和扣带回（p=0.005）的总HV（p=0.004）和总WMLs体积，达到80%的精度，81%的特异性,74%的灵敏度。较低的HV与Rey听觉言语学习测试延迟回忆（RAVLT）和迷你精神状态检查（MMSE）的表现较差有关。
结论：HV和WML是VMCI向VaD进展的重要预测因子。在RAVLT和MMSE测试中，较低的HV与较差的认知表现相关。
