期刊：Neurology 影響因子：11.8 

題目：Association of Cerebral Small Vessel Disease and  Cognitive Decline After Intracerebral  Hemorrhage

詞匯：1.cerebral small vessel didease (CSVD）腦小血管疾病 

          2.cognitive decline 認(rèn)知減退

          3.intracerebral hemorrhage（ICH）腦出血

翻譯：腦小血管疾病與腦出血后認(rèn)知衰退的關(guān)系

Abstract

Objective 目的

To determine whether MRI-based cerebral small vessel disease (CSVD) burden assessment, in addition to clinical and CT data, improved prediction of cognitive impairment after spontaneous intracerebral hemorrhage (ICH).

詞匯：1.cognitive impairment 認(rèn)知障礙 

翻譯：為了確定基于 MRI 的腦小血管疾病 (CSVD) 負(fù)擔(dān)評估是否除了臨床和 CT 數(shù)據(jù)外，還能改善對自發(fā)性腦出血 (ICH) 后認(rèn)知障礙的預(yù)測。

Methods 方法

We analyzed data from ICH survivors enrolled in a single-center prospective study. We employed 3 validated CSVD burden scores: global, cerebral amyloid angiopathy (CAA) -speci?c, and hypertensive arteriopathy (HTNA)–speci?c. We quanti?ed cognitive performance by administering the modi?ed Telephone Interview for Cognitive Status test. We utilized linear mixed models to model cognitive decline rates, and survival models for new-onset dementia. We calculated CSVD scores’cuto?s to maximize predictive performance for dementia diagnosis.

詞匯：1.linear mixed models 線性混合模型

          2.cutoffs 截?cái)嘀?/span>

翻譯：我們分析了參加單中心前瞻性研究的 ICH 幸存者的數(shù)據(jù)。我們采用了 3 種經(jīng)過驗(yàn)證的 CSVD 負(fù)擔(dān)評分：全球性、腦淀粉樣血管病 (CAA) 特異性和高血壓動脈病 (HTNA) 特異性。我們通過管理修改后的認(rèn)知狀態(tài)電話訪談測試來量化認(rèn)知表現(xiàn)。我們使用線性混合模型來模擬認(rèn)知衰退率和新發(fā)癡呆的生存模型。我們計(jì)算了 CSVD 分?jǐn)?shù)的截?cái)嘀担宰畲笙薅鹊靥岣甙V呆診斷的預(yù)測性能。

拓展：線性混合模型？

建模公式DV~IV+（1+R.Slope/R.Factor)

IV:固定因子，要考察的變量

Random factor 隨機(jī)因子

1/random intercept 不同個(gè)體因變量分布不同（1：隨機(jī)截距）

random slope 不同個(gè)體自變量與因變量關(guān)系不同（隨機(jī)斜率）

Results

We enrolled 612 ICH survivors, and followed them for a median of46.3 months (interquartile range 35.5–58.7). A total of 214/612 (35%) participants developed dementia. Higher global CSVD scores at baseline were associated with faster cognitive decline (coe?cient ?0.25,standard error [SE] 0.02) and dementia risk (sub–hazard ratio 1.35, 95% con?dence interval 1.10–1.65). The global score outperformed the CAA and HTNA scores in predicting post-ICH dementia (all p < 0.05). Compared to a model including readily available clinical and CT data, inclusion of the global CSVD score resulted in improved prediction of post-ICH dementia (area under the curve [AUC] 0.89, SE 0.02 vs AUC 0.81, SE 0.03, p = 0.008 for comparison). Global CSVD scores ≥2 had highest sensitivity (83%) and speci?city (91%) for dementia diagnosis.

詞匯：1.interquartile range 四分位距

翻譯：我們招募了 612 名 ICH 幸存者，平均隨訪 46.3 個(gè)月（四分位距 35.5-58.7）。共有 214/612 (35%) 名參與者患上了癡呆癥?；€時(shí)全球 CSVD 得分越高，認(rèn)知能力下降越快（系數(shù) -0.25，標(biāo)準(zhǔn)誤差 [SE] 0.02）和癡呆風(fēng)險(xiǎn)（亞風(fēng)險(xiǎn)比 1.35，95% 置信區(qū)間 1.10-1.65）。全球分?jǐn)?shù)在預(yù)測 ICH 后癡呆方面的表現(xiàn)優(yōu)于 CAA 和 HTNAscores（所有 p < 0.05）。與包含現(xiàn)成臨床和 CT 數(shù)據(jù)的模型相比，納入全球 CSVD 評分可改善對 ICH 后癡呆的預(yù)測（曲線下面積 [AUC] 0.89，SE 0.02 對比 AUC 0.81，SE 0.03，p = 0.008比較）。全球CSVD評分≥2對癡呆診斷具有最高的敏感性（83%）和特異性（91%）。

Conclusions

A validated MRI-based CSVD score is associated with cognitive performance after ICH and improved diagnostic accuracy for predicting new onset of dementia.

翻譯：經(jīng)驗(yàn)證的基于 MRI 的 CSVD 評分與 ICH 后的認(rèn)知表現(xiàn)相關(guān)，并提高了預(yù)測新發(fā)癡呆癥的診斷準(zhǔn)確性。

（9.08）持續(xù)更新

Intracerebral hemorrhage (ICH) is among the most severe forms of acute stroke, accounting for almost half of stroke-related morbidity and mortality.Recent advances in ICH surgical management and neurocritical care resulted in reduced mortality, but did not consistently reduce disability among survivors. Multiple recent studies clari?ed that ICH survivors are at very high risk of poststroke dementia, with cognitive impairment being a primary contributor to ICH-related long-term disability.Identi?cation of ICH survivors at high risk for cognitive impairment is therefore a priority, in order to guide secondary stroke prevention e?orts and inform further research into amelioration of long-term ICH outcomes.