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Relationship between White Matter Lesions and Progression of Cognitive Decline in Alzheimer's Disease

机译：老年痴呆症中白色物质病变与认知能力下降的关系

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Background: This study examined the relationship between baseline white matter lesions (WMLs) and the progression of cognitive decline in patients with late-onset Alzheimer's disease (AD). Methods: Fifty-six patients with AD were included in the study (23 men, 33 women; mean age, 77.8 years). All subjects were treated with acetylcholinesterase inhibitors and followed up for approximately 1 year. The Mini-Mental State Examination (MMSE) score was assessed at least twice to evaluate the progressive cognitive impairment. All subjects underwent brain MRI at baseline and were divided into WMLs(-), mild WMLs(+), and moderate WMLs(+) groups based on WML severity. Changes in MMSE scores between baseline and follow-up were analyzed using the Wilcoxon signed-rank test. Results: MMSE scores at baseline did not differ significantly among the three groups (p = 0.1658), whereas MMSE scores at the follow-up evaluation were significantly lower in the moderate WMLs(+) group than in the WMLs(-) group (p = 0.0257). The mean MMSE scores remained above baseline values during the approximately 1-year follow-up in the WMLs(-) group, whereas they were decreased in the mild and moderate WMLs(+) groups. Moreover, the frequency of improvement in patients from the WMLs(-) group tended to be higher than that in patients from the WMLs(+) groups. Conclusion: Baseline WMLs may be associated with the heterogeneous progression of cognitive decline in patients with AD.
机译：背景：这项研究检查了基线白质病变（WMLs）与迟发性阿尔茨海默氏病（AD）患者认知能力下降进展之间的关系。方法：本研究共纳入56例AD患者（男23例，女33例;平均年龄77.8岁）。所有受试者均接受乙酰胆碱酯酶抑制剂治疗，并随访约1年。至少评估了两次轻度精神状态检查（MMSE）评分，以评估进行性认知障碍。所有受试者均在基线时接受了脑部MRI检查，并根据WML严重程度分为WML（-），轻度WML（+）和中度WML（+）组。使用Wilcoxon符号秩检验分析基线和随访之间MMSE得分的变化。结果：三组患者的基线MMSE评分无显着差异（p = 0.1658），而中度WMLs +组的随访评估MMSE评分显着低于WMLs（-）组（p = 0.0257）。在大约1年的随访中，WMLs（-）组的平均MMSE得分仍高于基线值，而轻度和中度WMLs（+）组的平均MMSE得分却有所下降。此外，WMLs（-）组患者的改善频率往往高于WMLs（+）组患者。结论：基线WML可能与AD患者认知能力下降的异质性进展有关。

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