边缘区损伤与认知功能下降关系的临床分析(附20例报告)

目的探讨脑边缘区损伤与认知功能下降的关系。方法搜集20例因各种原因造成脑边缘区损伤在我院住院的病例,男14例,女6例;全部病例均行常规MRI检查,对每病例进行认知功能测定,并与MRI表现对比分析;同时,还与10例老年性痴呆患者进行MRI改变及认知功能下降程度的对比研究。结果(1)边缘区损伤的原因多以缺血性损伤为主,MRI表现为长T1长T2异常信号灶,而对照组主要表现为颞叶、海马及大脑皮层的萎缩;(2)20例患者的MMSE评分介于13~25分之间,平均19.7分,以记忆力及计算力下降为主;对照组的MMSE评分为6~15分,平均11分,定向力、记忆力、注意力和计算力、回忆力及语言能力的评分全面下降;(3)单纯边缘区损伤组的认知障碍程度与边缘区合并了豆状核其它部位损伤组无明显差异。结论边缘区是人脑与学习及记忆功能相关的一个新区,脑边缘区的损伤可引起认知功能的下降。

Clinical analysis of the relationship between injury of the marginal division and cognitive impairment

Objective To investigate the relationship between injury in the marginal division (MrD) of the striatum and thecognitive impairment. Methods Twenty patients with injury in the MrD of the striatum were examined routinely by magneticresonance imaging (MRI). Cognitive tests of each patient were performed and the results evaluated against their MRI findings.A comparative study of the MRI features and the degree of cognitive impairment was also performed between these patientsand 10 patients with Alzheimer's disease (AD). Results Ischemic injury was the main cause of MrD injuries, manifested byabnormal signals (long T1 and T2 signals) in the MrD. The findings in the 10 AD patients were characterized by atrophy of thetemporal lobe, hippocampus and the cortex. The average mini-mental-status examination (MMSE) score of the 20 patients was 19.7, with impaired memory and computation abilities as the main manifestations of cognitive impairments. The averageMMSE score in the AD group was 11, and the cognitive impairments included all aspects of the cognitive function. Nosignificant difference of the cognitive impairment was noted between the patients with only injury in the MrD and those withalso the injury in other areas of the striatum. Conclusion The MrD is probably a new area related to the memory function ofthe brain, and the injury of MrD may cause cognitive impairment.