Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).

Objective To observe the expression of peroxisome proliferator-activated receptor γ (PPARγ) in hippocampus neurons in rats after different time of neuron oxygen deprivation/oxygen supply, and to investigate the role of PPARγ in neuron ischemia reperfusion injury.Methods One day old newborn SD rats were chosen. Primary cultured hippocampus neurons were used to establish neuron ischemic reperfusion model in vitro by oxygen and glucose depriving 15 minutes and supplying again, and then the neuron structure was observed by transmission electron microscope of JEM-200EX.The expression of PPARγ mRNA and protein were detected by RT-PCR and Western blot, respectively.Results Neuron structure was damaged after neuron oxygen deprivation/oxygen supply. There was no significant difference between 0 h oxygen supply group and the control group.The expression of PPARγ was decreased both at mRNA and protein level after 6 h of oxygen supply. The difference between 6 h oxygen supply group and the control group was significant(P<0.01), which decreased with the length of reperfusion and the lowest was at 48 h after the reperfusion. The difference among the different reperfusion groups and the control group was significant(P<0.01). Conclusion PPARγ may participate in the pathological damage course of neuron ischemical reperfusion injury, and may become a new intervention target of treatment for ischemic cerebrovascular disease.

OBJECTIVETo investigate whether DTI abnormalities in patients with nondemented subcortical ischemic vascular disease (SIVD) are correlated to general cognitive function and executive function independent of conventional MRI parameters.

METHODSSixty-six SIVD patients including 30 with cognitive impairment without dementia (VCIND) and 36 with normal cognition (NCI) underwent DTI and cognitive assessment of the general cognitive function and executive function. Conventional MRI parameters and DTI parameters were measured within the white matter lesions (WMLs), normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM). The independent predictors of general cognitive function and executive function in SIVD patients was analyzed.

RESULTSNCI and VCIND patients showed significant differences in the periventricular WMLs, ADC valus in NAWM and WMLs of the centrum semiovale, and FA values in NAWM of the anterior periventricular. Except for ADC values of the caudate nucleus, ADC and FA values in the subcortical NAGM showed significant difference between the two groups. After controlling for age and education, PVLs and ADC values in the WMLs and NAWM of the centrum semiovale and putamen, and FA values in the anterior periventricular NAWM, WMLs and putamen showed significant correlations to MMSE; the number of lacunar infarcts, ADC values in posterior periventricular NAWM and caudate nucleus, and FA values in anterior periventricular NAWM and thalamus showed significant correlations to CDT. Multivariate analysis showed independent correlations of the ADC values in WMLs and NAWM of the centrum semiovale to MMSE, and demonstarted correlations of the ADC values of the caudate nucleus and number of lacunar infarcts to CDT.

CONCLUSIONIn nondemented SIVD subjects, the integrity of the white matter in the centrum semiovale strongly correlates to the general cognition, and the microstructural damage of the caudate nucleus head predicts executive function impairment independent of other MRI variables.

Brain Ischemia ; pathology ; physiopathology ; psychology ; Case-Control Studies ; Caudate Nucleus ; pathology ; Cerebral Cortex ; pathology ; Cognition ; physiology ; Cognition Disorders ; pathology ; physiopathology ; Diffusion Tensor Imaging ; Humans ; Magnetic Resonance Imaging