| Objective:1. To compare the differences of memory deficits in patients with amnesic mild cognitive impairment(aMCI) or vascular cognitive impairment-no dementia (VCIND).2. To investigate the relationships between memory deficits and executive and attention function,sleep disturbance and hippocampus atrophy and leukodystrophy in patients with either aMCI or VCIND3. To compare the feature of cerebral hemodynamic changes and the association between the changes with cognition in patients with either aMCI or VCIND.Methods:1. One hundred and twenty patients with aMCI(n=60) and non-dementia VCI(n=60) from memory clinic of Tianjin Medical University General Hospital and 40 age and sex-matched healthy controls are enrolled. The Hopkins Verbal Learning Test(HVLT) is used to assess the memory, semantic clustering ratio and serial position effects. The Trail Making Test-A/B(TMT-A/B) and the Wisconsin Card Sorting Test(WCST) are used to evaluate the executive function,the Paced Auditory Serial Addition Test(PASAT) and the Symbol Digit Modalities Test(SDMT) are used to assess the information processing and attention, and the Pittsburgh Sleep Quality Index(PSQI)is used to estimate the sleep condition. In addition,all the subjects are conducted cerebral magnetic resonance imaging(MRI).The Fazekas scale and medial temprol lobe atrophy standardized visual scale are used to evaluate the conditions of leukodystrophy and hippocampus atrophy respectively. So the relationships between memory deficits and executive and attention function, sleep disturbance and leukodystrophy and hippocampus atrophy.2. Sixty-two patients with aMCI(n=30) or VCIND(n=32) and 20 healthy controls from the participants above, who are in the context of informed consent, conduct the carotid color Doppler flow imaging and Transcranial Color Doppler(TCD) checks in Tianjin Medical University General Hospital. We record the peak systolic velocity(PSV) and resistance index(RI) of common carotid artery(CCA)and internal carotidartery(ICA), as well as, the mean flow velocity(Vm) and pulsatility index(PI) of anterior cerebral artery(ACA), middle cerebral artery(MCA), posterior cerebral artery(PCA), vertebral artery(VA)and basilar artery(BA) to investigate the brain blood flow deficits.Results:1. The characteristics of free recall deficitsThere were no significant differences in sex, age, years of education, handness and ADL(P>0.05). In general, the scores of controls are higher than the other groups in all tests. Compared with VCIND, aMCI have higher scores of TMTA, TMTB, WCST,PASAT and SDMT(P<0.05), but the scores of learning test 2(L2) and 3(L3), delay recall, recognition, semantic clustering of L2 and L3 and primacy were decreased,compared with controls(P<0.05), but there are no differences in recency effect among the three groups(P>0.05).2. The relationships between memory deficits and executive and attention function,sleep disturbance and leukodystrophy and hippocampus atrophy.The scores of L1-3 recall and delay recall in both aMCI and VCIND are negatively related to the scores of executive function(TMTB, WCST)(P<0.05)and sleep disturbance(sleep quality, sleep duration and sleep efficiency)(P<0.05), and are positively related to the scores of attention function(PASAT and SDMT)(P<0.05).The MTA scores of aMCI and the Fazekas scores of VCIND are negatively related to L1-3 semantic clustering ratio(SCR)(P<0.05), delay SCR(P<0.05).3. The features of cerebral hemodynamic changesThere were no significant differences in sex, age, years of education and handness(P>0.05). Compared to controls, aMCI and VCIND groups have lower PSV of LCCA,RCCA and LICA(P<0.05), higher RI of LCCA and LICA(P<0.05); lower Vm of LMCA, RMCA and higer PI of LMCA, RMCA, LACA, RACA(P<0.05); the VCIND group has higher RI of RCCA, lower Vm of LACA, LPCA and RPCA(P<0.05) and more soft plaques, hard plaques and mixed plaques of carotid artery(P<0.05).Compaired to the VCIND group, the aMCI group has lower PI of the LMCA?RMCA?LPCA?RPCA and LVA(P<0.05). The Vm of anterior circulation in both aMCI and VCIND groups shows positive relationships with the scores ofPASAT?SDMT?L1-3 recall and delay recall(P<0.05) and nagetive relationships with TMTB WCST(P<0.05). In addition, the PI of anterior circulation in the VCIND group is nagetively related with the scores of SDMT?L1-3 recall and delay recall(P<0.05) and positively related with the scores of TMTB.Conclusions:1. Both aMCI and VCIND individuals had marked deficts in semantic and positional strategies during the memory process; and these deficits of the aMCI individuals are more serious than VCIND. Recency effect was relatively preserved in both aMCI and VCIND.2. The number of verbal recall and semantic clustering had a certain relationship with brain atrophy, white matter lesions, executive function and sleep disturbance.3. Both aMCI and VCIND individuals had significant reduced brain blood flow and declined cerebrovascular compliance, and these changes of the VCIND individuals are more obvious than aMCI.4.There is a certain relationship between cerebral hemodynamic changes and cognitive deficits in patients with either aMCI or VCIND?... |
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