Cognitive function change characteristics and diagnostic efficiency analysis of related indexes after white matter lesions in patients with asymptomatic middle cerebral artery stenosis
10.3969/j.issn.1671-8348.2024.12.004
- VernacularTitle:无症状大脑中动脉狭窄患者脑白质病变后认知功能变化特征和相关指标的诊断效能分析
- Author:
Shiyi ZUO
1
;
Yong LIU
;
Yuting FENG
Author Information
1. 陆军军医大学第二附属医院疼痛与康复医学科,重庆 400037
- Keywords:
middle cerebral artery stenosis;
asymptomatic;
cognitive function assessment;
Montreal cognitive assessment scale;
mini-mental state examination scale
- From:
Chongqing Medicine
2024;53(12):1778-1783
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the characteristics of white matter lesions(WMLs)causing cognitive function change in the patients with asymptomatic middle cerebral artery(MCA)stenosis,and to analyze the diagnostic efficiency of related indexes.Methods Thirty-nine patients diagnosed with asymptomatic MCA ste-nosis and presenting with WMLs in the department of neurology of the hospital from 2021 to 2022 were in-cluded as the observation group,and 34 healthy people were included as the control group.The two groups conducted the behavioral assessment of cognitive function,such as the Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Test of Connectivity Type A(TMT),Digit Symbol Test(SDMT),Digit Breadth Test(DST),Drawing the Clock Test(CDT),and Verbal Fluency Test(VFT).The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of related indica-tors.Results In the single cognitive function assessment scales,the scores of TMT in the observation group were significantly higher than those in the control group(P＜0.01),the scores of SDMT,DST,CDT and VFT in the observation group were significantly lower than those in the control group and the differences were sta-tistically significant(P＜0.01).In the comprehensive cognitive function assessment scales,the total scores of MMSE and MoCA in the observation group were significantly lower than those in the control group(P＜0.01).In the scores of each factor of the MMSE scale,the verbal ability in the observation group was signifi-cantly lower than that in the control group(P＜0.01),but the scores of orientation,memory,attention,calcu-lation and recall were had no statistically significant differences between the two groups(P＞0.05).In the scores of each factor of MoCA,the visuospatial and executive ability,delayed memory,attention and abstrac-tion ability in the observation group were significantly lower than those in the control group(P＜0.01),but the scores of naming ability,attention ability and orientation ability had no statistically difference(P＞0.05).The area under the ROC curve(AUC),sensitivity and specificity of MoCA and MMSE were 0.80,0.73,0.52,0.71,0.92 and 0.74 respectively.The efficiency of MoCA for diagnosing cognitive function disorders caused by asymptomatic MCA stenosis was higher.Conclusion Compared with single cognitive function assessment scale,the comprehensive cognitive function assessment scales could more comprehensively and accurately screen the cognitive function disorders caused by WMLs in the patients with asymptomatic MCA stenosis,in which the diagnostic efficiency of MoCA is the highest.
