脑膜瘤患者伽玛刀治疗后脑白质损伤与认知功能的关系
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摘要
目的探讨脑膜瘤患者伽玛刀治疗后脑白质损伤与患者认知功能的关系。方法 89例接受伽玛刀治疗的脑膜瘤患者在伽玛刀治疗前及治疗后1月、6月,分别进行磁共振检查(FLAIR序列),采用脑白质高信号Schelten评分评估脑白质损伤严重程度;同时以蒙特利尔认知评估量表(MoCA)评定患者认知功能。结果①治疗后1月、6月患者Schelten评分均较治疗前显著增高,差异均有统计学意义(t=4.066,5.376;P=0.000);②治疗后1月、6月患者MoCA评分均较治疗前显著下降,差异均有统计学意义(t=2.370,2.265;P=0.019,0.024);③治疗后1月、6月时患者的Schelten评分与MoCA评分之间有负性相关(r=-0.308,-0.402;P=0.038,0.007)。结论伽玛刀治疗可致脑膜瘤患者脑白质损伤,并与其认知功能的降低有关。
Objective To explore the correlations between impairment of white matter and cognitive function in patients with meningioma after gamma knife radiotherapy. Methods 89 cases of meningioma patients receiving gamma knife radiotherapy were rolled. MRI( FLAIR sequences) and Montreal Cognitive Assessment Scale( MoCA) were determined before and 1,6 month after gamma knife radiotherapy. Schelten's score of white matter hyperintensities and MoCA were used for evaluation of impairment of white matter or cognitive function respectively. Results The Schelten's score was significantly increased 1,6 month after gamma knife radiotherapy compared with that before treatment( t = 4. 066,5. 376; both P = 0. 000),while the score of MoCA siginificantly decreased( t = 2. 370,2. 265; P =0. 019,0. 024). The Schelten's score showed a negative correlation with the score of MoCA at time point of 1,6 month after gamma knife radiotherapy( r =-0. 308,-0. 402; P = 0. 038,0. 007). Conclusion The impairment of white matter following gamma knife radiotherapy may induce a decline of cognitive function in patients with meningioma.
Objective To explore the correlations between impairment of white matter and cognitive function in patients with meningioma after gamma knife radiotherapy. Methods 89 cases of meningioma patients receiving gamma knife radiotherapy were rolled. MRI( FLAIR sequences) and Montreal Cognitive Assessment Scale( MoCA) were determined before and 1,6 month after gamma knife radiotherapy. Schelten's score of white matter hyperintensities and MoCA were used for evaluation of impairment of white matter or cognitive function respectively. Results The Schelten's score was significantly increased 1,6 month after gamma knife radiotherapy compared with that before treatment( t = 4. 066,5. 376; both P = 0. 000),while the score of MoCA siginificantly decreased( t = 2. 370,2. 265; P =0. 019,0. 024). The Schelten's score showed a negative correlation with the score of MoCA at time point of 1,6 month after gamma knife radiotherapy( r =-0. 308,-0. 402; P = 0. 038,0. 007). Conclusion The impairment of white matter following gamma knife radiotherapy may induce a decline of cognitive function in patients with meningioma.
引文
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[12]Tartaglia M C,Rosen H J,Miller B I.Neuroimaging in dementia[J].Neurotherpeutics,2011,89(1):82-92
[13]易峰,苏旭江,汪艳.躯体形式障碍患者认知功能情况与事件相关电位P300的研究[J].中国健康心理学杂志,2012,20(12):1829-1832
[14]刘晓伟,刘亮,邹凯,等.帕利哌酮对首发精神分裂症的疗效和认知功能的影响[J].中国健康心理学杂志,2012,20(11):1611-1613
[15]den Heijer T,Geerlings M I,Hoebeek F E,et a1.Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predic dementia in cognitively intact elderly people[J].Arch Gen Psychiatry,2006,63(1):57-62
[16]Manschot S M,Brands A M A,Vander Grond J.Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2diabetes[J].Diabetes,2006,55(4):1106-1113
[17]Dropcho E J.Neurotoxicity of radiationtherapy[J].Neurol Clin,2010,28(1):217-234
[18]刘强.放射性脑损伤研究现状[J].国外医学:放射医学核医学分册,2004,28(4):178-181
[2]Dumal C M,Lunsford L D,Kondiziolka D,et a1.Stereotactic radiosurgery of cavernous sinus meningioma asan addition or alternative to microsurgery[J].Neurosurgery,2008,32(4):699-672
[3]Kwon K H,Lee J I,Hong S C,et a1.Gamma knife radiosurgery for epilepsy related to dysembryoplastic neuroepithelial tumor[J].Stereotact Funct Neurosurg,2006,84(5-6):243-247
[4]黄国栋,罗鸣,屈晓飞,等.电离辐射抑制海马区神经发生与放射性脑损伤认知损害的关系[J].中华放射医学与防护杂志,2013,33(2):113-118
[5]Dropcho E J.Neurotoxicity of radiation therapy[J].Neurol Clin,2010,28(1):217-234
[6]Tartaglia M C,Rosen H J,Miller B I.Neuroimaging in dementia[J].Neurotherpeutics,2011,89(1):82-92
[7]李桂花,宋永斌,杨俊,等.癫痫患者认知功能与心理健康状态的关系[J].中国健康心理学杂志,2011,19(6):656-658
[8]Scheltens P,Barkhof F,Leys D,et a1.A semiquantitive rating scale for the assessment of sign al hyperintensities on magnetic resonance imaging[J].J Neurol Sci,1993,114(1):7-12
[9]黄纯臣,李林昕,韩翔,等.胆碱能通路损伤在血管性认知功能障碍中的作用[J].中华神经科杂志,2010,43(9):612-616
[10]袁文佳,涂彧,崔凤梅.放射性脑损伤的发病机制及治疗[J].国际放射医学核医学杂志,2008,32(4):250-254
[11]Kutita H,Kawahara N,Asai A,et al.Radiation-induced apoptosis of oligendrocytes in the adult rat brain[J].Neurol Res,2001,23(8):869-874
[12]Tartaglia M C,Rosen H J,Miller B I.Neuroimaging in dementia[J].Neurotherpeutics,2011,89(1):82-92
[13]易峰,苏旭江,汪艳.躯体形式障碍患者认知功能情况与事件相关电位P300的研究[J].中国健康心理学杂志,2012,20(12):1829-1832
[14]刘晓伟,刘亮,邹凯,等.帕利哌酮对首发精神分裂症的疗效和认知功能的影响[J].中国健康心理学杂志,2012,20(11):1611-1613
[15]den Heijer T,Geerlings M I,Hoebeek F E,et a1.Use of hippocampal and amygdalar volumes on magnetic resonance imaging to predic dementia in cognitively intact elderly people[J].Arch Gen Psychiatry,2006,63(1):57-62
[16]Manschot S M,Brands A M A,Vander Grond J.Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2diabetes[J].Diabetes,2006,55(4):1106-1113
[17]Dropcho E J.Neurotoxicity of radiationtherapy[J].Neurol Clin,2010,28(1):217-234
[18]刘强.放射性脑损伤研究现状[J].国外医学:放射医学核医学分册,2004,28(4):178-181