Impact of total cerebral small vessel disease burden on cognitive function in patients with minor ischemic stroke
10.3760/cma.j.issn.1673-4165.2024.10.005
- VernacularTitle:脑小血管病总体负担对轻型缺血性卒中患者认知功能的影响
- Author:
Mingzhi ZHANG
1
;
Li CHEN
;
Ruolan TANG
;
Xiaona XING
Author Information
1. 深圳大学附属第三医院，深圳 518000
- Keywords:
Ischemic stroke;
Severity of illness index;
Cerebral small vessel diseases;
Cognition disorders;
Magnetic resonance imaging
- From:
International Journal of Cerebrovascular Diseases
2024;32(10):747-753
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of total cerebral small vessel disease (CSVD) burden on cognitive function in patients with minor ischemic stroke.Methods:Patients with first-ever acute minor ischemic stroke (AMIS) admitted to the Department of Neurology, Shenzhen Luohu District People's Hospital from January 2021 to December 2023 were included prospectively. According to the total CSVD burden score, they were divided into 0-2-point group, 3-point group, and 4-point group. According to the Clinical Dementia Rating (CDR) score at 6 months after onset, they were divided into a cognitively normal group and a post-stroke cognitive impairment (PSCI) group. The cognitive function assessment was conducted at 6 months after onset. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess the overall cognitive function. The Auditory Verbal Learning Test-Huashan version (AVLT-H) was used to assess memory, the Trail Making Test (TMT) was used to assess executive function and attention, the Boston Naming Test (BNT) was used to assess language ability, and the Clock Drawing Test (CDT) was used to assess visual spatial function. Multivariate logistic regression analysis was used to determine the independent influencing factors of PSCI. Results:A total of 111 patients with AMIS were enrolled, including 53 males (47.7%), aged 69.18±7.41 years. 77 cases (69.4%) in 0-2-point group, 18 cases (16.2%) in 3-point group, and 16 cases (14.4%) in 4-point group; 39 cases (35.1%) experienced PSCI. Univariate analysis showed that age, and the proportion of patients with hypertension, diabetes, smoking, total CSVD burden score of 3 and 4 in the PSCI group was significantly higher than those in the cognitive normal group (all P<0.05), and the years of education was significantly lower than that in the cognitive normal group ( P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors (age, years of education, hypertension, diabetes, smoking), the total CSVD burden score 3 (compared with 0-2 points: odds ratio [ OR] 16.627, 95% confidence interval [ CI] 3.548-77.925; P<0.001) and 4 (compared to 0-2 points: OR 4.435, 95% CI 1.786-11.011; P=0.001) were the independent risk factors for PSCI. There were significant differences in MMSE, MoCA, AVLT-H, TMT-A, TMT-B, CDT, and CDR scores among different total CSVD burden score groups at 6 months after onset (all P<0.05). The overall cognitive function and functional scores of various cognitive domains gradually decreased with the increase of total CSVD burden score in patients with AMIS at 6 months after onset. Conclusions:In patients with AMIS with higher total CSVD burden at 6 months after onset, their overall cognitive function, memory, executive function, attention, and visual spatial function are decreased, and the incidence of PSCI is significantly increased.
