Impact of stent implantation on cognitive function in patients with cognitive dysfunction and middle cerebral artery stenosis
10.13929/j.1672-8475.201808004
- Author:
Jijie ZHANG
1
Author Information
1. Graduate School of Hebei Medical University
- Publication Type:Journal Article
- Keywords:
Cognition;
Middle cerebral artery;
Perfusion imaging;
Stents;
Tomography, X-ray computed
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(2):71-76
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the impact of stent implantation on cognitive function in patients with mild-to-moderate cognitive dysfunction associated with severe stenosis of unilateral middle cerebral artery (MCA) M1 segment. Methods: According to whether stent implantation, 28 patients with mild-to-moderate cognitive dysfunction associated with unilateral MCA M1 severe stenosis were divided into treatment group (n=13) and control group (n=15). The examinations of mini-mental state examination (MMSE) score, Montreal cognitive assessment (MoCA) score and the event-related potential P300 were performed on all patients in treatment group 1 week before stent implantation and 6, 12 months after implantation,as well as in control group during the same period. Totally 5 patients in treatment group underwent CT perfusion imaging (CTP) 1 week before stent implantation and 1 month after implantation. Cerebral blood flow (CBF) and cerebral blood volume (CBV) were measured and the ratios of CBF and CBV between the affected side and contralateral side (rCBF and rCBV) were calculated. Meanwhile, mean transit time (MTT), peak time (TTP) and the differences of between the two sides (dMTT and dTTP) were obtained, and then statistical analysis was performed. Results: There was no significant difference of MMSE and MoCA scores, nor the latency and amplitude of P300 between the two groups 1 week before stent implantation (all P>0.05). However, 6 and 12 months after implantation and the corresponding period, the differences were statistically significant between the two groups (all P<0.05). In treatment group, the differences of the scores of MMSE and MoCA were statistically significant 1 week before stent implantation, 6 and 12 months after implantation (all P<0.05). The pairwise comparison showed that the scores of MMSE and MoCA 12 months after stent implantation were higher than those 1 week before implantation (both P<0.05), and the score of MoCA 6 months after implantation was higher than that 1 week before implantation (P=0.010). There was no significant difference of the latency and amplitude of P300 between the two groups 1 week before stent implantation (both P>0.05). The latencies in treatment group were shorter than those in control group 6 and 12 months after stent implantation (both P<0.01), while the amplitude were higher than those in control group (both P<0.05). In treatment group, the latency and amplitude of P300 were statistically significant 1 week before stent implantation, 6 and 12 months after implantation (all P<0.05). The pairwise comparison showed that the latencies of 6 and 12 months after stent implantation were shortened (both P<0.01), while the amplitude increased compared with those on 1 week before implantation (both P<0.05). Compared with 6 months after stent implantation, the latency on 12 months after implantation was shortened (P=0.010). In treatment group, no matter whether there were risk factors or not, no significant difference of the scores of MMSE nor MoCA among 1 week before stent implantation, 6 and 12 months after implantation (all P>0.05). Of 5 patients underwent CTP examination in treatment group, rCBF 1 month after stent implantation was higher than that 1 week before stent implantation (P<0.01), while rCBV, dMTT and dTTP were lower than those 1 week before implantation (all P<0.05). Conclusion: Stent implantation can improve cognitive function in patients with severe stenosis of MCA M1 segment through increasing blood flow of cerebral artery. Cognitive function changes can be detected earlier by latency of P300 than by MMSE score.
