【摘要】 目的探讨脑小血管病(CSVD)冻结步态(FOG)患者的临床、影像、认知及步态特征。方法选择就诊于我院神经科CSVD-FOG患者6例,收集患者临床及影像资料,采用改良的Rankin量表(mRS)评分、Barthel指数(BI)和日常生活活动能力量表(ADL)评估日常生活能力。采用简易智能状态检查量表(MMSE),蒙特利尔认知评估量表(MoCA)评估认知功能。结果 3例(50.0%)存在淡漠,4例(66.7%)在过去1年内不明原因跌倒至少1次。BI≥90分4例(66.7%),ADL≥5分4例(66.7%),mRS评分2分4例(66.7%)。所有患者影像上均出现脑白质高信号、腔隙、有局限皮质和深部/混合脑微出血及血管周围间隙。5例(83.3%)CSVD影像总负荷为3分,1例(16.7%)为4分。6例患者均有基底核区病变,5例患者有脑干区病变。MMSE评分为(23.50±5.13)分,MoCA评分为(16.67±5.05)分,步速为(0.52±0.37)m/s,右步长为(0.20±0.06)m,左步长为(0.21±0.03)m,步宽为(0.18±0.02)m, 3 m转身用时(4.05±3.60)s。结论 CSVD-FOG患者临床可合并多种脑血管病危险因素,同时合并多个认知域及步态域受损,可能对FOG发生起重要作用。更多还原

【Abstract】 Objective To study the clinical, imaging, cognitive and gait characteristics of CSVD patients with FOG.Methods The clinical and imaging data of 6 CSVD patients with FOG were recorded.The ADL of the patients was assessed according to their mRS score, BI and ADL scale score.The cognitive function of the patients was evaluated according to their MMSE scale score and MoCA scale score.Results Indifference was detected in 3 patients(50.0%),falling due to unknown reasons occurred once at least in the past year in 4 patients(66.7%),BI was ≥90 in 4 patients(66.7%),ADL was ≥5 in 4 patients(66.7%),mRS score was 2 in 4 patients(66.7%).MRI showed white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces in all the 6 CSVD patients with FOG.The total CSVD score was 3 in 5 patients(83.3%) and 4 in 1 patient(16.7%).Region of interest-based analysis showed basal ganglia and brainstem lesions in all the 6 patients and brainstem lesions in 5 patients.The MMSE scale score, MoCA scale score, step speed, right step distance, left step distance, step width and 3-m turning around time of the CSVD patients with FOG were 23.50±5.13,16.67±5.05,0.52±0.37 m/s, 0.20±0.06 m, 0.21±0.03 m, 0.18±0.02 m, 4.05±3.60 s respectively.Conclusion A variety of risk factors for cerebrovascular diseases are detected in CSVD patients with FOG,cognitive impairment and gait impairment, which may play an important role in the occurrence of FOG.更多还原