■在特发性正常压力脑积水(iNPH)患者中观察到扣带回沟征(CSS),提示在脑脊液循环和受损的淋巴系统的潜在破坏。尽管脑小血管病(CSVD)和iNPH之间的潜在机制相似,CSS和CSVD之间的关系尚不清楚。本研究旨在探讨CSVD患者CSS的患病率和潜在机制。
■回顾性收集2020年1月至2022年10月在中国医科大学附属盛京医院诊断为CSVD的患者的数据,包括一般信息,全球认知功能[通过测量迷你精神状态检查(MMSE)评估],和四个CSVD磁共振成像(MRI)标记[(白质高强度(WMH),脑微出血(CMBs),lacunes,和扩大的血管周围空间(EPVS)],CSS和Evan索引(EI)。
■共纳入308名患者,在80例患者(26%)中检测到CSS。单因素分析显示,CSS组的MMSE评分明显低于非CSS组(p<0.001)。多变量分析显示CSS与缺失的存在之间存在独立的相关性(优势比[OR]0.358,95%置信区间[CI]0.193-0.663,p=0.001),存在大叶显性CMBs(OR2.683,95CI1.385-5.195,p=0.003),脑室WMHFazekas评分(OR1.693,95%CI1.133-2.529,p=0.01),和EI(OR1.276,95%CI1.146-1.420,p<0.001)。
■这项初步研究表明,在某些CSVD患者中可以观察到CSS。CSS的存在可能代表CSVD发病机制的不同,并反映了脑脊液(CSF)/间质液(ISF)停滞程度的差异。
UNASSIGNED: The cingulate sulcus sign (CSS) has been observed in patients with idiopathic normal pressure hydrocephalus (iNPH), suggesting potential disruptions in cerebrospinal fluid circulation and compromised glymphatic system. Although there are similarities in the underlying mechanisms between cerebral small vessel disease (CSVD) and iNPH, the relationship between CSS and CSVD remains unclear. This study aimed to investigate the prevalence and potential mechanisms of CSS in patients with CSVD.
UNASSIGNED: Data from patients diagnosed with CSVD at Shengjing Hospital of
China Medical University between January 2020 and October 2022 were retrospectively collected, including general information, global cognitive function [assessed by measuring Mini-Mental State Examination (MMSE)], and four CSVD magnetic resonance imaging (MRI) markers [(white matter hyperintensity (WMH), cerebral microbleeds (CMBs), lacunes, and enlarged perivascular spaces (EPVS)], CSS and the Evan\'s index (EI).
UNASSIGNED: A total of 308 patients were included, and CSS was detected in 80 patients (26%). Univariate analysis revealed that MMSE scores in the CSS group were significantly lower compared to the non-CSS group (p < 0.001). Multivariable analysis showed an independent correlation between CSS and the presence of lacunes (odds ratio [OR] 0.358, 95% confidence interval [CI] 0.193-0.663, p = 0.001), presence of lobar dominant CMBs (OR 2.683, 95%CI 1.385-5.195, p = 0.003), periventricular WMH Fazekas score (OR 1.693, 95% CI 1.133-2.529, p = 0.01), and EI (OR 1.276, 95% CI 1.146-1.420, p < 0.001).
UNASSIGNED: This preliminary study showed that CSS can be observed in some patients with CSVD. The presence of CSS may represent different mechanisms of CSVD pathogenesis and reflect differences in the degree of cerebrospinal fluid (CSF)/interstitial fluid (ISF) stasis.