Study On The Collateral Circulation, Attention Function And Event-related Potentials Of Patients With Asymptomatic Internal Carotid Stenosis Or Occlusion

Objective: To explore the effect of collateral circulation open type on Asymptomatic Carotid Artery Stenosis(ACS),occlusion patients’ attention function and event-related potential.Methods :Select 66 cases of patients with asymptomatic internal carotid artery stenosis and occlusion were diagnosed by DSA or CTA in the department of neurology of the affiliated hospital of southwest medical university,divided into 3 groups: 25 patients with no collateral circulation open(NCCO),26 with primary collateral circulation open(PCCO),21 with secondary collateral circulation open(SCCO).The normal control group(25 cases)matched with gender,age and education were selected.Complete the following tests for all patients:1,Collect general information,biochemical indexes and imaging data;2,Overall cognitive function detection:Using the simple mental state checklist(MMSE)and the Montreal cognitive assessment scale(MoCA),the total scores and MoCA scores were calculated respectively;3,Computer aided neuropsychological comparison:The Continuous Performance Task(CPT),Stroop(Stroop)and two-task test were used respectively for Continuous attention,attention and distraction;4,ERPs:the amplitude and latency of P3 a and P3 b were observed in the visual Oddball stimulus mode;5,analysis the correlation attention function and P3 a,p3b.Results:1,Four groups in age,gender,history of hypertension,smoking history,and history of diabetes by the difference in general data such as no statistical significance(P>0.05).2,There was no statistically significant difference in MMSE total score between four groups(F=0.916,P=0.612>0.05).The total score of MOCA during the four groups was different,and the difference was statistically significant(F=4.31,P=0.031<0.05),NCCO group got lower scores in MoCA compaired with NC group(P=0.015<0.05),PCCO group(P=0.024<0.05),and the difference statistically significant.Item of MoCa compairsion.In the attention score,there was a significant difference during the four groups(F=2.173,P=0.021<0.05).NCCO group got lower scors in attention score with NC group(P=0.017<0.05),PCCO group(P=0.017<0.05).3,Computer aided neuropsychological comparison:(1)Continuous Performance Task(CPT):Reaction time in CPT had significantly prolonged and omission rate had increased in NCCO group compared with PCCO group(P<0.05),NC group(P<0.01).(2)Stroop test:reaction time under neutral condition and conflict condition had significantly prolonged(P<0.05),stroop effect under conflict and neutral conditions had prolonged(P=0.011<0.05)in NCCO group compared with PCCO group and NC group.error rate under conflict conditions had significantly increased and interfered effects of error rate under conflict and neutral had increased(P=0.010<0.05)in NCCO group compared with NC group.(3)Dual task:NOOC group did worse in dual task than PCCO group(P=0.018<0.05),NC group(P=0.009<0.01).4,ERPs:(1)P3a’s and P3b’s scalp distribution characteristics:P3a amplitude in the forehead is higher than the occipital(P=0.000<0.05).P3 b latency and amplitude had no difference in frontal,central and occipital(P>0.05).(2)P3a latency and amplitude:Latency of P3 a had significantly prolonged and amplitude had declined in NCCO group compared with PCCO group and NC group(P<0.05);Amplitude of P3 a had significantly declined(P=<0.05)but Latency had no prolonged(P>0.05)in NCCO group compared with SCCO group;amplitude of P3 a had significantly declined(P<0.05)in SCCO group compared with NC group.(4)P3b latency and amplitude:Amplitude of P3 b had significantly declined(P<0.05)but latency had prolonged in NCCO group compared with PCCO group and NC group(P>0.05).5,Correlation analysis: P3 a latency and amplitude had good correlations with Dual task;P3b amplitude had a good correlation with Stroop test interfered effect.Conclusions:1,The patients’ attentional function with asymptomatic internal carotid artery stenosis and occlusion were impaired,and the MoCA scale was more sensitive than MMSE.2,Asymptomatic internal carotid artery stenosis,occlusive patients sustained attention,selective attention,dispersive attention all have damage.Collateral circulation can reduce the damage.3.Asymptomatic patients with severe internal carotid artery stenosis,occlusion’ event-related potentials P3 a,P3b respectively and divided attention and selective attention has good correlation,P3 a,P3b can be used as reflect its attention to impaired nerve electrophysiology index.