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脑小血管病相关性研究进展
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Abstract:
脑小血管病(cerebral small vessel disease, CSVD)是起病隐匿，随着年龄增长而逐渐进展，最终使患者丧失独立性的病变。先前大多数研究表明步态障碍与影响认知功能的神经退行性病变相关，随着影像学发展，近年来一直未被引起足够重视的脑小血管病对步态功能的影响受到大众关注，本文主要对CSVD影像学检查、发病机制、治疗和不同类型脑小血管病与步态障碍相关性研究进展进行综述。
Cerebral small vessel disease is insidious in nature, progressing gradually with age and ultimately leading to a loss of patient independence. Previous studies have consistently demonstrated an association between gait disorder and neurodegenerative conditions that impact cognitive function. With the advancement of imaging technology, the impact of cerebral small vessel disease on gait function, a topic that has been overlooked in recent years, has garnered public attention. This article provides a comprehensive review of research progress in imaging examinations, pathogenesis, treatment, and the correlation between different types of cerebral small vessel disease and gait disorders.
| [1] | 王伊龙. 重视脑小血管病的步态障碍[J]. 中华医学杂志, 2019, 99(9): 641-643. |
| [2] | 张枘南, 王伊龙. 脑小血管病与卒中防治的“异”与“同” [J]. 中风与神经疾病杂志, 2024, 41(1): 7-13. |
| [3] | 王辉, 李云霞, 刘梦, 等. 无卒中患者脑小血管病总负荷与颅内外动脉硬化的相关性研究[J]. 医学临床研究, 2022, 39(1): 13-17, 22. |
| [4] | Wardlaw, J.M., Smith, E.E., Biessels, G.J., et al. (2013) Neuroimaging Standards for Research into Small Vessel Disease and Its Contribution to Ageing and Neurodegeneration. The Lancet Neurology, 12, 822-838. |
| [5] | van den Brink, H., Doubal, F.N. and Duering, M. (2022) Advanced MRI in Cerebral Small Vessel Disease. International Journal of Stroke, 18, 28-35. https://doi.org/10.1177/17474930221091879 |
| [6] | Duering, M., Biessels, G.J., Brodtmann, A., Chen, C., Cordonnier, C., de Leeuw, F., et al. (2023) Neuroimaging Standards for Research into Small Vessel Disease—Advances since 2013. The Lancet Neurology, 22, 602-618. https://doi.org/10.1016/s1474-4422(23)00131-x |
| [7] | Raja, R., Rosenberg, G. and Caprihan, A. (2019) Review of Diffusion MRI Studies in Chronic White Matter Diseases. Neuroscience Letters, 694, 198-207. https://doi.org/10.1016/j.neulet.2018.12.007 |
| [8] | Sun, C., Wu, Y., Ling, C., Xie, Z., Sun, Y., Xie, Z., et al. (2021) Reduced Blood Flow Velocity in Lenticulostriate Arteries of Patients with CADASIL Assessed by PC-MRA at 7T. Journal of Neurology, Neurosurgery & Psychiatry, 93, 451-452. https://doi.org/10.1136/jnnp-2021-326258 |
| [9] | 王伊龙, 陈玮琪, 叶瑾怡, 等. 脑小血管病: 回眸2022 [J]. 中国卒中杂志, 2023, 18(1): 1-16. |
| [10] | Pasi, M. and Cordonnier, C. (2020) Clinical Relevance of Cerebral Small Vessel Diseases. Stroke, 51, 47-53. https://doi.org/10.1161/strokeaha.119.024148 |
| [11] | Gao, Y., Li, D., Lin, J., Thomas, A.M., Miao, J., Chen, D., et al. (2022) Cerebral Small Vessel Disease: Pathological Mechanisms and Potential Therapeutic Targets. Frontiers in Aging Neuroscience, 14, Article 961661. https://doi.org/10.3389/fnagi.2022.961661 |
| [12] | Wardlaw, J.M., Smith, C. and Dichgans, M. (2019) Small Vessel Disease: Mechanisms and Clinical Implications. The Lancet Neurology, 18, 684-696. https://doi.org/10.1016/s1474-4422(19)30079-1 |
| [13] | Zanon Zotin, M.C., Sveikata, L., Viswanathan, A. and Yilmaz, P. (2021) Cerebral Small Vessel Disease and Vascular Cognitive Impairment: From Diagnosis to Management. Current Opinion in Neurology, 34, 246-257. https://doi.org/10.1097/wco.0000000000000913 |
| [14] | Patwa, J. and Flora, S.J.S. (2020) Heavy Metal-Induced Cerebral Small Vessel Disease: Insights into Molecular Mechanisms and Possible Reversal Strategies. International Journal of Molecular Sciences, 21, Article 3862. https://doi.org/10.3390/ijms21113862 |
| [15] | 王芳, 曹俊杰, 伊晶晶, 等. 前馈控制在老年脑小血管病步态障碍患者跌倒管理中的应用研究[J]. 护理管理杂志, 2023, 23(9): 689-694. |
| [16] | 龚晓芹, 钟平, 曹立. 神经科疾病常用的步态评估方法[J]. 中华神经科杂志, 2022, 55(2): 174-180. |
| [17] | Ogama, N., Endo, H., Satake, S., Niida, S., Arai, H. and Sakurai, T. (2021) Impact of Regional White Matter Hyperintensities on Specific Gait Function in Alzheimer's Disease and Mild Cognitive Impairment. Journal of Cachexia, Sarcopenia and Muscle, 12, 2045-2055. https://doi.org/10.1002/jcsm.12807 |
| [18] | 焦爱菊, 赵玮婧, 文淑梅, 等. 步态运动学特征及MRI总负荷与脑小血管病步态障碍患者跌倒风险的相关性研究[J]. 中国康复医学杂志, 2024, 39(1): 70-75. |
| [19] | Zhang, W., Low, L., Schwenk, M., Mills, N., Gwynn, J.D. and Clemson, L. (2019) Review of Gait, Cognition, and Fall Risks with Implications for Fall Prevention in Older Adults with Dementia. Dementia and Geriatric Cognitive Disorders, 48, 17-29. https://doi.org/10.1159/000504340 |
| [20] | Pinter, D., Ritchie, S.J., Gattringer, T., Bastin, M.E., Hernández, M.d.C.V., Corley, J., et al. (2018) Predictors of Gait Speed and Its Change over Three Years in Community-Dwelling Older People. Aging, 10, 144-153. https://doi.org/10.18632/aging.101365 |
| [21] | Heiland, E.G., Welmer, A., Kalpouzos, G., Laveskog, A., Wang, R. and Qiu, C. (2021) Cerebral Small Vessel Disease, Cardiovascular Risk Factors, and Future Walking Speed in Old Age: A Population-Based Cohort Study. BMC Neurology, 21, Article No. 496. https://doi.org/10.1186/s12883-021-02529-6 |
| [22] | Zhang, Z., Ren, W., Shao, B., Xu, H., Cheng, J., Wang, Q., et al. (2017) Leukoaraiosis Is Associated with Worse Short-Term Functional and Cognitive Recovery after Minor Stroke. Neurologia medico-chirurgica, 57, 136-143. https://doi.org/10.2176/nmc.oa.2016-0188 |
| [23] | Wardlaw, J.M., Chabriat, H., de Leeuw, F., Debette, S., Dichgans, M., Doubal, F., et al. (2024) European Stroke Organisation (ESO) Guideline on Cerebral Small Vessel Disease, Part 2, Lacunar Ischaemic Stroke. European Stroke Journal, 9, 5-68. https://doi.org/10.1177/23969873231219416 |
| [24] | Gattringer, T., Valdes Hernandez, M., Heye, A., Armitage, P.A., Makin, S., Chappell, F., et al. (2019) Predictors of Lesion Cavitation after Recent Small Subcortical Stroke. Translational Stroke Research, 11, 402-411. https://doi.org/10.1007/s12975-019-00741-8 |
| [25] | Caplan, L.R. (2015) Lacunar Infarction and Small Vessel Disease: Pathology and Pathophysiology. Journal of Stroke, 17, 2-6. https://doi.org/10.5853/jos.2015.17.1.2 |
| [26] | Poggesi, A., Pasi, M., Pescini, F., Pantoni, L. and Inzitari, D. (2015) Circulating Biologic Markers of Endothelial Dysfunction in Cerebral Small Vessel Disease: A Review. Journal of Cerebral Blood Flow & Metabolism, 36, 72-94. https://doi.org/10.1038/jcbfm.2015.116 |
| [27] | 孟启哲, 奚志, 王铭, 等. 2型糖尿病合并近期皮质下小梗死患者血糖变异性与梗死负担及认知功能障碍的相关性研究[J]. 中国全科医学, 2023, 26(15): 1885-1891. |
| [28] | 谢遵敏, 王青银, 李宇, 等. 腔隙性脑梗死病人血管周围间隙扩大的影响因素探讨[J]. 安徽医药, 2022, 26(1): 112-115. |
| [29] | Zhuo, J., Raghavan, P., Shao, M., Roys, S., Liang, X., Tchoquessi, R.L.N., et al. (2024) Automatic Quantification of Enlarged Perivascular Space in Patients with Traumatic Brain Injury Using Super-Resolution of T2-Weighted Images. Journal of Neurotrauma, 41, 407-419. https://doi.org/10.1089/neu.2023.0082 |
| [30] | Hicks, A.J., Sinclair, B., Shultz, S.R., Pham, W., Silbert, L.C., Schwartz, D.L., et al. (2023) Associations of Enlarged Perivascular Spaces with Brain Lesions, Brain Age, and Clinical Outcomes in Chronic Traumatic Brain Injury. Neurology, 101, e63. https://doi.org/10.1212/wnl.0000000000207370 |
| [31] | Liu, J.Y., Zhou, Y.J., Zhai, F.F., Han, F., Zhou, L., Ni, J., et al. (2020) Cerebral Microbleeds Are Associated with Loss of White Matter Integrity. American Journal of Neuroradiology, 41, 1397-1404. https://doi.org/10.3174/ajnr.a6622 |
| [32] | 李金泽, 张罗今, 冯捷, 等. 脑微出血的数量和位置分布与脑小血管病的影像学相关性研究[J]. 磁共振成像, 2023, 14(10): 46-52. |
| [33] | Hou, Y., Yang, S., Li, Y., Qin, W., Yang, L. and Hu, W. (2023) Impact of Cerebral Microbleeds on Gait, Balance, and Upper Extremities Function in Cerebral Small Vessel Disease. Journal of Integrative Neuroscience, 22, Article No. 82. https://doi.org/10.31083/j.jin2204082 |
| [34] | Zhang, X., Lu, H., Fan, M., Tian, W., Wang, Y., Cui, M., et al. (2024) Bidirectional Mediation of Bone Mineral Density and Brain Atrophy on Their Associations with Gait Variability. Scientific Reports, 14, Article No. 8483. https://doi.org/10.1038/s41598-024-59220-2 |
| [35] | 熊思宁, 郭瑞, 陈宁, 等. 基于不同运动亚型的帕金森脑灰质体积及自发活动功能的临床研究[J]. 放射学实践, 2023, 38(9): 1108-1113. |
| [36] | Yao, D., Li, S., Jing, J., Cai, X., Jin, A., Yang, Y., et al. (2022) Association of Serum Cystatin C with Cerebral Small Vessel Disease in Community-Based Population. Stroke, 53, 3123-3132. https://doi.org/10.1161/strokeaha.122.039277 |
| [37] | 梁梅芳, 杨辉, 周世玲, 等. 血清CysC、TGF-β1对老年腔隙性脑梗死患者早期神经功能恶化的预测价值[J]. 脑与神经疾病杂志, 2023, 31(1): 44-48. |
| [38] | Li, Z. and Xin, Z. (2020) Expression and Significance of S-100β, CysC and NF-κB in Patients with Acute Cerebral Infarction. Experimental and Therapeutic Medicine, 21, Article No. 149. https://doi.org/10.3892/etm.2020.9580 |
| [39] | Song, H., Bharadwaj, P.K., Raichlen, D.A., Habeck, C.G., Huentelman, M.J., Hishaw, G.A., et al. (2023) Association of Homocysteine-Related Subcortical Brain Atrophy with White Matter Lesion Volume and Cognition in Healthy Aging. Neurobiology of Aging, 121, 129-138. https://doi.org/10.1016/j.neurobiolaging.2022.10.011 |
| [40] | Blumen, H.M., Jayakody, O. and Verghese, J. (2022) Gait in Cerebral Small Vessel Disease, Pre-Dementia, and Dementia: A Systematic Review. International Journal of Stroke, 18, 53-61. https://doi.org/10.1177/17474930221114562 |
| [41] | Koohi, F., Harshfield, E.L., Shatunov, A. and Markus, H.S. (2024) Does Thrombosis Play a Causal Role in Lacunar Stroke and Cerebral Small Vessel Disease? Stroke, 55, 934-942. https://doi.org/10.1161/strokeaha.123.044937 |
| [42] | Su, C., Liu, W., Li, G. and Huang, Y. (2021) Association between the Angiotensin-Converting Enzyme I/D Polymorphism and Risk of Cerebral Small Vessel Disease: A Meta-Analysis Based on 7186 Subjects. Journal of Stroke and Cerebrovascular Diseases, 30, Article ID: 105579. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105579 |
| [43] | 刘静怡. 低频NOTCH3基因变异与脑小血管病相关性研究[D]: [博士学位论文]. 北京: 中国医学科学院, 2021. |
| [44] | Xu, S., Li, H., Li, S., Ren, Q., Liang, J. and Li, C. (2023) Heterozygous Pathogenic and Likely Pathogenic Symptomatic HTRA1 Variant Carriers in Cerebral Small Vessel Disease. International Journal of General Medicine, 16, 1149-1162. https://doi.org/10.2147/ijgm.s404813 |
| [45] | 哈拉木江·赛力克, 孔祥锋. ICAM-1与脑小血管病关系的研究[J]. 中国实用神经疾病杂志, 2019, 22(8): 922-928. |
| [46] | Benavente OR, Hart RG, McClure LA, et al. (2012) Effects of Clopidogrel Added to Aspirin in Patients with Recent Lacunar Stroke. New England Journal of Medicine, 367, 817-825. https://doi.org/10.1056/nejmoa1204133 |
