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Abstract(s)
Introdução: as doenças neurodegenerativas são um importante problema de saúde pública nos países desenvolvidos e a sua prevalência está em constante crescimento, acompanhando a longevidade cada vez maior da população. Actualmente, não existe um marcador definitivo de diagnóstico. A adopção de biomarcadores neurorradiológicos (TC) para a identificação precoce do DCL e da DA assume cada vez mais uma posição de destaque.
Objectivo: experimentar a TC como potencial exame epidemiológico para aplicação complementar da clínica na relação ―vascular-cognitiva‖ do idoso.
Métodos: neste estudo retrospectivo procedeu-se à recolha (durante o ano de 2009) de 77 TC-CE escolhidas de forma randomizada, sendo 63,6% de indivíduos do sexo feminino e 36,4% do sexo masculino (região Médio Tejo). Constituiram-se 3 grupos de acordo com a informação clínica providenciada na requisição do exame: grupo I (informação inespecífica, sem factores de risco cérebro-vascular), grupo II (risco vascular sem referência a alteração cognitiva) e grupo III (referência a possível declínio cognitivo). As variáveis avaliadas e correlacionadas foram: a informação clínica, a idade, as lacunas, o ângulo do corpo caloso (ACC), o hipocampo, o parahipocampo, a cisura coroideia, o corno temporal e a hipodensidade justafrontal. Procuramos obter relação significativamente estatística (p<0,05) através da análise intergrupal e relacionando cada variável com a informação clínica e consequente grupo. Utilizaram-se vários testes estatísticos (teste exacto de Fisher, teste K-S, 2 de pearson, ETA, Ró de Spearman) e efectuou-se análise descritiva inicial e análise discriminante final.
Resultados: as variáveis que apresentaram relação com a informação clínica foram: a idade (excepto na diferenciação entre o grupo II e III), as lacunas (p=0,001), a espessura do hipocampo (excepto na distinção entre o grupo II e III), a espessura das hipodensidades frontais (p=0,01). Houve diferenças na significância estatística entre o lado esquerdo e direito de algumas estruturas medidas: a largura do corno temporal esquerdo (p=0,003) e direito (p=0,276). Sem relação com a informação clínica: o ACC (p=0,307), o giro uncal do parahipocampo esquerdo (p=0,362) e direito (p=0,053); a altura da cisura coroideia esquerda (p=0,201) e direita (p=0,597).
Conclusão: são argumentos de analogia clínica a espessura do hipocampo inferior a 3,2 mm (marcador de eleição) e ao qual deve associar-se outros marcadores (companheiros): as lacunas, a espessura das hipodensidades frontais justaventriculares e, de forma integrada/associada, o ACC e a largura dos cornos temporais.
Introduction: neurodegenerative diseases are a major public health problem in developed countries and its prevalence is growing steadily following the increasing longevity of the population. Currently, there is none definitive diagnostic marker. The adoption of neuroradiological biomarkers (computed tomography - CT) for early identification of mild cognitive impairment (MCI) and Alzheimer disease (AD) is increasingly assuming a position of excellence. Objective: to experience the CT as a potential epidemiological survey and to complement the clinical symptoms in the elderly. Methods: this retrospective study was carried with the randomly collection of 77 cranial CT (during the year of 2009) being 63,6% females and 36,4 males (Middle Tagus region). We have formed three groups according to the clinical information provided in the requesto f the examination: group I (non-specific information without cerebrovascular risk factors), group II (without reference of cognitive-vascular impairment) and group III (reference to possible cognitive decline). The analysed and variables were: clinical information, age, lacunar infarcts, angle of the corpous callosum (ACC), hippocampus, parahippocampus, choroidal scission, temporal horn and justafrontal hypodensity. We seek to obtain statistically significant relationship (p<0,05) by intergroup analysis and correlating each variable with the clinical information and his group. We used various statistical tests (Fisher’s exact test, K-S test, pearson 2 , ETA, spearman rho) as well as descriptive and discriminant analysis. Results: the variables correlated with the clinical information are: the age (except in the differentiation between the group II and the group III), the lacunar infarcts (p=0,001), the thickness of the hippocampus (except in the distinction between the group II and the group III), thickness of the frontal hipodensity (p=0,01). There were also diferences in statistical significance between the left and the right structures of the wodth of the left temporal horn (p=0,003) and the right (p=0,276). No relation to clinical information: the ACC (p=0,307), uncal gyrus of the left parahippocampus (p=0,362) and of the right (p=0,053), the thickness of the left choroidal scission (p=0,201) and of the right (p=0,597). Conclusion: the measures of clinical analogy are the hippocampus thickness under 3,2 millimeters (marker of choice) to whom other markers sould be associate: the lacunar infarcts, the thickness of the frontal hipodensity and, in a integrated/associated manner, the ACC and the width of the temporal horns.
Introduction: neurodegenerative diseases are a major public health problem in developed countries and its prevalence is growing steadily following the increasing longevity of the population. Currently, there is none definitive diagnostic marker. The adoption of neuroradiological biomarkers (computed tomography - CT) for early identification of mild cognitive impairment (MCI) and Alzheimer disease (AD) is increasingly assuming a position of excellence. Objective: to experience the CT as a potential epidemiological survey and to complement the clinical symptoms in the elderly. Methods: this retrospective study was carried with the randomly collection of 77 cranial CT (during the year of 2009) being 63,6% females and 36,4 males (Middle Tagus region). We have formed three groups according to the clinical information provided in the requesto f the examination: group I (non-specific information without cerebrovascular risk factors), group II (without reference of cognitive-vascular impairment) and group III (reference to possible cognitive decline). The analysed and variables were: clinical information, age, lacunar infarcts, angle of the corpous callosum (ACC), hippocampus, parahippocampus, choroidal scission, temporal horn and justafrontal hypodensity. We seek to obtain statistically significant relationship (p<0,05) by intergroup analysis and correlating each variable with the clinical information and his group. We used various statistical tests (Fisher’s exact test, K-S test, pearson 2 , ETA, spearman rho) as well as descriptive and discriminant analysis. Results: the variables correlated with the clinical information are: the age (except in the differentiation between the group II and the group III), the lacunar infarcts (p=0,001), the thickness of the hippocampus (except in the distinction between the group II and the group III), thickness of the frontal hipodensity (p=0,01). There were also diferences in statistical significance between the left and the right structures of the wodth of the left temporal horn (p=0,003) and the right (p=0,276). No relation to clinical information: the ACC (p=0,307), uncal gyrus of the left parahippocampus (p=0,362) and of the right (p=0,053), the thickness of the left choroidal scission (p=0,201) and of the right (p=0,597). Conclusion: the measures of clinical analogy are the hippocampus thickness under 3,2 millimeters (marker of choice) to whom other markers sould be associate: the lacunar infarcts, the thickness of the frontal hipodensity and, in a integrated/associated manner, the ACC and the width of the temporal horns.
Description
Keywords
Tomografia computorizada - Risco cognitivo Doenças neurodegenerativas - Idoso Leucoaraiosis Doença de Alzheimer - Idoso
Pedagogical Context
Citation
Publisher
Universidade da Beira Interior