Objective To study the characteristics of cognitive function changes in patients with cerebellar infarction, and to clarify the association between cerebellar infarction and cognitive function. Methods A total of 106 patients with cerebellar infarction, admitted to our hospital from June 2017 to December 2018, and 55 healthy subjects recruited at the same time were chosen. National Institute of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits, and modified International Cooperative Ataxia Rating Scale (ICARS) was used to evaluate balance function. The cognitive function differences of the two groups were compared by Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Patients with cerebellar infarction were divided into different subgroups according to different courses of disease, different infarction sites and different cerebellar hemispheres to further compare the cognitive functions of the subjects. Results (1) In terms of cognitive function evaluation, the scores of MoCA and Rey auditory word learning test (RAVLT) in the cerebellar infarction group were significantly lower than those in the control group, and the time consumption of Trail Making Test (TMT)-B was significantly longer than that in the control group (P<0.05). (2) MoCA and RAVLT scores in the acute cerebellar infarction group were significantly lower than those in the non-acute cerebellar infarction group (P<0.05). (3) There were significant differences in ICARS scores, MoCA scores, RAVLT scores and TMT-B time consumption between the anterior cerebellar infarction group and the posterior cerebellar infarction group (P<0.05). (4) The time consumption of TMT-B of right cerebellar infarction patients was significantly longer ([258.85 ±55.96] s) than that in left cerebellar infarction patients ([198.22 ±40.43] s, P<0.05). Conclusions There are cognitive dysfunctions, especially memory and executive function, in patients with cerebellar infarction, which is correlated with the disease period and location of cerebellar infarction, but not with infarct volume. Cognitive dysfunction is more obvious in patients with acute cerebellar infarction, posterior cerebellar infarction and right cerebellar infarction than those in patients with non-acute cerebellar infarction, anterior cerebellar infarction and left cerebellar infarction.

Objective To investigate the diagnostic value of next-generation sequencing (NGS) in α-herpes virus meningitis or encephalitis.Methods A multicenter clinical registration study of encephalitis based on Department of Neurology of Peking Union Hospital from July 2015 to July 2018 was performed;15 patients with meningitis or encephalitis caused by α-herpes virus in Nanjing Brain Hospital and Peking Union Hospital were identified by NGS of cerebrospinal fluid (CSF).The verification results of further CSF virus PCR or antibody detection,the results of lumbar puncture,electroencephalogram and MRI detection,and the nucleic acid sequence analysis results of background bacteria in these 15 patients were observed.Results In these 15 patients with CSF α-herpes virus infection,8 were with herpes simplex virus (HSV)-1 infection,two with HSV-2 infection and 5 with varicella zoster virus (VZV) infection;four were further tested by CSF virus PCR,and 8 were further tested by antibody IgM,and the results were all positive.The protein content in CSF biochemical examination was slightly increased to (0.91±0.50) g/L.EEG abnormalities were observed in 9 patients;MR imaging abnormalities were observed in 6 patients with HSV-1 encephalitis,presenting as abnormal high signals in MR imaging T2 phase in the medial temporal lobe,hippocampus,cingulate gyrus and insula,which could be mainly involved in one side or both sides simultaneously.Eleven patients had fever,and the highest temperature was (38.6±0.61) ℃;13 patients had headache,8 had abnormal mentalbehavior and 7 had decreased consciousness.All patients showed different levels of suspicious background microorganisms;the most common background bacteria were propionibacterium acacne (13.7％),staphylococcus epidermidis (9.59％),pseudomonas (8.22％) and acid-eating bacteria (6.85％).Conclusion CSF NGS could be used in diagnosis of intracranial α-herpes virus infection,which can be a supplement diagnostic method currently.

Objective:To explore the relations of changes in the cognitive function with brain structure network in patients with cerebellar infarction.Methods:Thirty-six patients with cerebellar infarction at the posterior lobe, admitted to our hospital from July 2016 to October 2019, were chosen as cerebellar infarction group; and 30 healthy subjects matched with age, gender, and education level at the same time period were used as control group. Neurocognitive and behavioral tests were performed on both groups to assess the cognitive functions, and MR imaging was performed to obtain diffusion tensor imaging (DTI) data. Deterministic tractography and graph theory were used to obtain the structural brain network and network parameters of all subjects. The differences of clinical data and brain network topological characteristic parameters between the two groups were compared, and the correlation between the subjects' brain structural network characteristic parameters and cognitive function was analyzed.Results:As compared with the control group, patients in the cerebellar infarction group had significantly lower Mini-mental State Examination (MMSE), Montreal Cognitive Scale (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Digit Span Test (DST), Clock Drawing Test (CDT) and Berg Balance Scale (BBS) scores, and significantly longer Trail Making Test (TMT) time-consuming ( P<0.05). As compared with the control group, the cerebellar infarction group showed significantly decreased global efficiency (Eglob) and local efficiency (Eloc) in the brain network, and significantly increased clustering coefficient (Cp) and length of path (Lp, P<0.05). As compared with the control group, the cerebellar infarction group had significantly reduced nodal efficiency in 14 brain regions ( P<0.05), including bilateral median cingulate and paracingulate gyri (DCG), left inferior frontal gyrus-opercular part (IFGoperc), bilateral supplementary motor area (SMA), bilateral precuneus (PCUN), left inferior frontal gyrus-orbital part (ORBinf), left temporal pole-superior temporal gyrus (TPOsup), left temporal pole-middle temporal gyrus(TPOmid), left inferior parietal-supramarginal and angular gyri (IPL), bilateral posterior cingulate gyrus (PCG), left inferior frontal gyrus-triangular part (IFGtriang). MoCA scores were significantly negatively correlated with Lp ( r=-0.388, P=0.019), and were significantly positively correlated with Eglob ( r=0.350, P=0.036), and efficiencies in the right DCG ( r=0.428, P=0.009), left DCG ( r=0.359, P=0.031) and right PCG ( r=0.350, P=0.037) in the cerebellar infarction patients. The RAVLT scores showed a significantly positive correlation with Eglob ( r=0.338, P=0.044). The TMT-A time-consuming and left DCG had significant negative correlation ( r=0.357, P=0.032). TMT-B time-consuming was significantly negatively correlated with right DCG ( r=-0.432, P=0.008), right PCUN ( r=-0.350, P=0.036) and left DCG ( r=-0.398, P=0.016), and positively correlated with Lp ( r=0.406, P=0.014). Conclusions:There is cognitive dysfunction in multiple domains after acute cerebellar infarction, including memory, executive function, visuospatial ability and attention. At the same time, there are reduced efficiency of information transmission in bilateral PCUN, PCG and DCG, and the frontal temporal lobe; among them, the abnormal changes of the right PCG, bilateral DCG, and right PCUN may play key roles in cognitive dysfunction.