Name: evaluation of the cognitive performance of hypertensive patients with silent cerebrovascular lesions
Uploaded: 2021-04-23T12:30:00
Description: Watch this Scientific Journal Video about Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions at JoVE.com

这项工作得到了匹配和捐赠基金的支持（脑血管研究基金、SHAC匹配赠款、教资会匹配赠款和威廉·蒙博士神经学研究基金授予张R.T.F.教授）。

研究协议获香港大学/医院管理局香港西组（港大/HA HKW IRB）机构检讨委员会批准，供人类研究之用。
1. 参与者
<ol><li>招募其他健康的中国老年受试者（从65岁到99岁，平均年龄72岁），有高血压史至少5年。</li>
	<li>排除患有任何影响认知功能和/或任何阻碍完成所需评估的疾病的参与者，包括但不限于中风、痴呆、脑炎、抑郁症、糖尿病和冠心病。</li>
	<li>在获得书面同意之前...

<ol>
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M., Chan, C. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stroop+interference+in+Chinese+and+English.">Stroop interference in Chinese and English.</a> Journal of Clinical and Experimental Neuropsychology. 22 (4), 465-471 (2000).</li><li>Gawryluk, J. R., Mazerolle, E. L., Beyea, S. D., D'Arcy, R. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+MRI+activation+in+white+matter+during+the+Symbol+Digit+Modalities+Test.">Functional MRI activation in white matter during the Symbol Digit Modalities Test.</a> Frontiers in Human Neuroscience. 8, 589 (2014).</li><li>Chiu, H. 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在这项研究中，我们结合了一系列神经心理学评估的结果和多序列MRI检查的结果，以评估不同类型的SCL对各种认知功能的影响。检查了主要类型的SCL（即CMC、SL和WMHs）。正如以前的研究表明，不同地点的SCL可能代表不同的病理学，并导致不同的后果，我们分类CMB和SL到严格的洛巴（即，只有长臂杆没有深的）和深的（有或没有洛巴），并将WMHs分为VBH和DWMH。选择一组结构化神经心理学测试，对涵盖...

沉默的乳腺（SLs）、脑微出血（CMB）和白质超密集（WMHs）被称为无声脑血管病变（SCLs）。确认两种类型的 WMHs：垂直 WMHs 和深层 WMHs。SCL曾经被认为是良性病变，没有临床意义。经过几十年的研究，SCL现在被证实与不同的功能障碍和认知缺陷1，2有关。然而，在不同类型的SCL的认知效应的谱系和规模方面，一致的证据仍然有限。此外，基本机制是难以捉摸的。
以往的大多数研究要么招募患有严重疾病3、4、5的医院病人，要么包括患有晚期脑小血管疾病6、7的参与者。不同研究参与者的异质性部分促成了结果的不一致。为了排除这些混淆因素，我们进行了目前的以单为中心的研究，试图通过评估从初级保健环境中招募的相对庞大、纯粹群体来提供清晰的图景。此外，以前的研究主要侧重于一种或两种类型的SCL，并没有充分评估单个SCL与特定认知功能之间的独立关联。因此，我们在本研究中评估了各种类型的SCL。
神经心理学测试广泛用于评估特定领域的认知功能。它们有助于区分正常衰老和早期认知障碍。正确进行的神经心理学评估结果对辨别行为和功能缺陷很敏感。选择了一系列结构化的神经心理学测试，包括向前和向后的数字跨度测试、符号数字模式测试 （SDMT）、斯特罗普测试、语言流利测试和蒙特利尔认知评估 （MoCA）。这些测试的分数被分组并组合在一起，以表示不同认知领域8、9的表现。这种方法被广泛使用，而且具有时间效益。一个主要缺点是，不同的神经心理学测试可能部分重叠在他们的测试领域。更具体的选择是使用基于计算机的评估，使用 E-Prime 系统构建设计良好的模块，该系统耗时且可能不适合筛选。
最后，我们旨在评估不同SCL的负担与不同认知领域损伤之间的关联。此外，血管危险因素和其他类型的SCL被控制，以确定每种类型的SCL认知障碍的明显和独立的轮廓。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>3T MRI</td>
			<td>Philips Medical Systems</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

evaluation of the cognitive performance of hypertensive patients with silent cerebrovascular lesions

过去十年积累的证据证明，无声脑血管病变（SCL）及其潜在的致病过程导致老年人认知能力下降。然而，每种病变对认知表现的明显影响仍不清楚。此外，中国老年人使用SCL的研究数据也很少。在这项研究中，包括了398名健康高血压老年受试者（72岁中位数）并进行了评估。所有参与者都必须完成一系列结构化的神经心理学评估，包括前后数字跨度测试、符号数字模式测试、斯特罗普测试、语言流利性测试和蒙特利尔认知评估。这些测试用于评估注意力、执行功能、信息处理速度、语言、记忆和视网空间功能。在神经心理学评估后一个月内安排了多序列的3T MRI扫描，以评估SCL的负担。脑微出血 （CMB） 和无声拉库内斯 （SLs） 分别根据位置被确定为严格腰杆 CCB 和 SL 或深 CCB 和 SL。同样，白质超密集（WMHs）被分为垂直WMHs（PVHs）和深层WMHs（DWMHs）。使用一系列线性回归模型来评估每种类型的 SCL 和单个认知功能域之间的相关性。结果表明，CCB往往会损害与语言相关的认知。深度 SL 影响执行功能，但在控制其他类型的 SCL 后，这种关联消失了。 PVH 与认知衰退有关，尤其是在执行功能和处理速度方面。结论是，SCL的不同方面对高血压老年中国人的认知能力有差异性影响。

398名参与者的平均年龄为72.0岁（从65岁到99岁，SD=5.1岁），男性为213岁（53.5%）：表3）。表4总结神经心理学评估结果。只有5名参与者拥有所有四种类型的SCL。在 169 （42.5%） 中发现了一种或多种 SCL 类型参与者，35 （8.8%）和 17 （4.3%）参与者分别有2种和3种SCL（表5）。
分别检查了光伏和DWM...

Watch this Scientific Journal Video about Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions at JoVE.com

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

在这里，我们提出了一个协议，通过神经心理学测试和多序列3T MRI扫描的组合，评估各类无声脑血管病变是否与398名高血压老年中国人中某些认知领域的缺陷有差异。

沉默脑血管病变高血压患者认知表现评估

Evidence accumulated from the last decade has proven that silent cerebrovascular lesions (SCLs) and their underlying pathogenic processes contribute to ...

沉默的脑血管病变可导致各种功能障碍和认知缺陷。然而，不同类型病变对认知表现的明显影响仍不清楚。通过神经心理测试和多序列MRI扫描，我们可以评估各种类型的脑血管病变是否与特定认知领域的缺陷有差异。展示研究程序将由我的研究官员高俊玲和我的技术官员林翠茜完成。要设置符号数字模式测试，将数字顺序中的一到九位数字与九个不关联的符号配对。进行了一系列结构化的神经心理测试，其中两项被选为演示。在开始测试之前，指示参与者用每个符号下方的正确配对数字填充空白。允许参与者在练习中填写前 10 个空白，指出练习阶段的任何错误，并鼓励参与者正确。当参与者准备好时，开始测试，鼓励参与者在 90 秒内尽快准确地填空。当参与者完成或时间用完时，记录正确响应的数量并重新启动测试，这次让参与者口头提供正确的对数。要评估语言流畅性，请参与者口头提供属于两个类别的名称列表，每个类别一分钟。然后记录每个类别列出的名称总数。要执行病变的视觉评级，请首先将数据导入适当的医疗成像软件程序，并使用匿名按钮使参与者的信息匿名化。要对视觉无声脑血管病变进行评分，首先定位无声的乳腺和T1加权水平图像，其中病变显示为直径为2至15毫米的低强化体。以预先指定的顺序从一侧搜索所有大脑区域，以避免任何遗漏。例如，从前叶内皮和罗勒结叶、叶叶、腹叶和腹叶、小脑和脑干进行搜索。为了确认无声的拉库内斯的存在，查看 FLAIR NT1 加权图像，其中可以观察到直径为 2 到 15 毫米的低强化叶，通常带有超强化边缘和 T2 加权图像，然后拉库内斯是高增量。要识别脑微出血为穿刺，或直径为两到十毫米的圆形椭圆形低强化体，将易感加权图像加载到软件中，并使用大脑观察器微出血量表将整个大脑区域划分为七个解剖位置。当所有病变都局限于皮层和皮下白质时，参与者被认为有严格的低杠脑微出血。要将白质增密性识别为双边的、几乎对称的超密集区域，可以查看 T2 加权和 FLAIR 图像。使用 Fazekas 比例得分，将垂直超密集度作为一级 foci 显示为大写或铅笔薄衬里，将光滑的光环作为二级，不规则信号作为三级延伸至深白质。将深白质超密集率显示为一级穿刺，小汇合区域为二级，大汇流区域为三级。在这项具有代表性的分析中，398名参与者的平均年龄为72岁，其中213名参与者是男性。这里显示了参与者的神经心理学评估结果。在169名参与者中发现了一种或多种无声脑血管病变，其中35名参与者展示了两种类型，17种表现出三种类型。只有5名参与者有所有四种类型的无声脑血管病变。这些数据证实，垂直白质超强度的负担与执行功能和信息处理速度的较差之间有独立的关联。脑微出血的负荷增加与语言相关性能受损有关，血管危险因素和其他类型的无声脑血管病变的额外调整不会影响脑微出血对语言功能的独立影响。虽然沉默的乳液的存在与执行功能表现不佳之间有显著关联，但在其他类型的无声脑血管病变进行额外矫正后，这种关联丢失了。虽然学习这种神经心理测试并不难，但几年来对数百名患者采用同样的标准化程序可能具有挑战性。应采用统一的标准，对参与者的神经心理学评估和MRI病变进行评级。应定期审查这些程序，以确保统一性。一些神经心理学测试在评估领域有重叠。将来，基于计算机的评估可以更精确，您的成像研究的其他功能可以应用于特定的认知领域。

Research

JoVE Journal

Behavior

A Method for Investigating Age-related Differences in the Functional Connectivity of Cognitive Control Networks Associated with Dimensional Change Card Sort Performance

针对调查中的认知控制网络与关联维度变化卡片分类性能的功能连通性年龄相关性差异的方法

The ability to adjust behavior to sudden changes in the environment develops gradually in childhood and adolescence. For example, in the Dimensional ...

科研

行为学

Irrelevant Stimuli and Action Control: Analyzing the Influence of Ignored Stimuli via the Distractor-Response Binding Paradigm

不相干的刺激和动作控制：通过分心 - 响应绑定范式忽略刺激的影响分析

Selection tasks in which simple stimuli (e.g. letters) are presented and a target stimulus has to be selected against one or more distractor stimuli are ...

The Attentional Set Shifting Task: A Measure of Cognitive Flexibility in Mice

在注意定势转移任务：测量小鼠认知的灵活性

Cognitive impairment, particularly involving dysfunction of circuitry within the prefrontal cortex (PFC), represents a core feature of many ...

The Emotional Stroop Task: Assessing Cognitive Performance under Exposure to Emotional Content

情绪Stroop任务：评估下暴露的认知表现的情感内容

The emotional Stroop effect (ESE) is the result of longer naming latencies to ink colors of emotion words than to ink colors of neutral words. The ...

A Pressure Injection System for Investigating the Neuropharmacology of Information Processing in Awake Behaving Macaque Monkey Cortex

对调查信息处理的神经药理学清醒行为猕猴皮质压力喷射系统

The top-down modulation of feed-forward cortical information processing is functionally important for many cognitive processes, including the modulation ...

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease

四山测试：空间记忆的一个简短的测试与高灵敏度的预痴呆诊断阿尔茨海默氏病

This protocol describes the administration of the 4 Mountains Test (4MT), a short test of spatial memory, in which memory for the topographical layout of ...

Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

眼跟踪控制，以评估患者的认知功能与肌萎缩性脊髓侧索硬化症

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to ...

The Other End of the Leash: An Experimental Test to Analyze How Owners Interact with Their Pet Dogs

皮带的另一端: 分析主人与宠物狗互动的实验测试

It has been suggested that the way in which owners interact with their dogs can largely vary and influence the dog-owner bond, but very few objective ...

Virtual Reality Experiments with Physiological Measures

用生理学方法进行虚拟现实实验

Virtual reality (VR) experiments are increasingly employed because of their internal and external validity compared to real-world observation and ...

Biomechanical Analysis Methods to Assess Professional Badminton Players' Lunge Performance

生物力学分析方法,以评估职业羽毛球运动员的隆起表现

Under the condition of simulating a badminton court in the laboratory, this study used the injury mechanism model to analyze the maximal right lunge ...