Abstract

Objective To explore the pathogenesis of age⁃related white matter changes (ARWMC), and to investigate the correlation between ARWMC and the number of circulating endothelial progenitor cells (EPCs) and cognitive function in order to provide evidence for early prevention and treatment of ARWMC and cognitive impairment in elderly people. Methods Forty patients with ARWMC were confirmed by CT or MRI. The number of circulating EPCs was measured by flow cytometry. The cognitive function was evaluated by Mini ⁃ Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). One way analysis of variance (ANOVA) of completely random design and χ2 test of R × C tabular data were used to select single factor. Logistic regression (backward) was performed to determine the risk factors for ARWMC. Results Flow cytometry showed that the number of circulating EPCs reduced in patients with ARWMC, especially in severe group (29.50 ± 6.26), and there was statistically significant difference compared with control group (70.50 ± 8.71) and mild⁃to⁃moderate group (58.99 ± 7.78; P = 0.000, for all). The number of circulating EPCs was negatively correlated with the severity of ARWMC (r = ⁃ 0.562, P = 0.001). The scores of MMSE (23.85 ± 2.35) and the scores of MoCA (19.80 ± 3.38) in severe group were significantly lower than control group (27.10 ± 1.80, 26.60 ± 1.23, respectively) and mild⁃to⁃moderate group (25.80 ± 2.02, 23.30 ± 2.87, respectively), and there was statistically significant difference between groups (P < 0.05, for all). Cognitive impairment was mainly presented on visuoconstructional and executive functions, delayed recall and orientation. Conclusion The change of the number of circulating EPCs can be a predictive factor for ARWMC, and it is a potential predictor of the severity of ARWMC. The decrease of the circulating EPCs may be an important pathogenesis of ARWMC, and also the important causation of cognitive impairment in elderly people. DOI:10.3969/j.issn.1672-6731.2010.03.015

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