The Effect Of Ischemic Cerebrovascular Disease On Attention Lateralization

Objective In recent years,the incidence of cerebrovascular disease has been increased on a global scale.Cerebrovascular stenosis is one of the major causes of ischemic cerebrovascular disease.Studies have shown an increase in cognitive impairment after cerebral infarction.Attention is widely regarded as the basis for other cognitive functions.Patients with cognitive impairment are often accompanied by attention disorders.Attention in both hemispheres is asymmetric.We often observed that patients with right hemisphere infarction are often accompanied by left space neglect,while left hemisphere infarction is rarely accompanied by symptoms of neglect.It is suggested that different hemispherical infarcts have different effects on attention lateralization.Therefore,in study 1 we uses LANT to investigate the effect of left and right hemisphere acute cerebral infarction on the lateralization of attention function.Other studies have shown that cerebral vascular stenosis can also cause cognitive impairment,especially the left vascular stenosis is more related to cognitive impairment.Therefore,in study 2 we uses LANT to investigate the changes of attentional bias before and after stent implantation in patients with left cerebral vascular stenosis.Methods Study 1:This study used the LANT to observe bilateral cerebral hemisphere on the efficiency of three attentional networks: altering,orienting and executive control in 36 patients with acute cerebral infarction and 18 healthy controls.Study 2 : This study used the LANT to compare before and after stent implantation on the efficiency of three attentional networks in 20 patients with left cerebral vascular stenosis which was confirmed by DSA.Results Study 1:For healthy controls,the response time of the right visual field was significantly longer than the left in the orienting function [t(17)=2.31,p<0.05].In the altering function and executive control function,there was no statistically significant difference in response time between the left and right visual fields.For the right hemisphere infarction group,the response time of the right visual field was significantly longer than the left in the orienting function [t(17)=3.46,p<0.01].In the altering function and executive control function,there was no statistically significant difference in response time between the left and right visual fields.In the left hemisphere infarction group,there was no statistically significant difference in the response time between the left and right visual fields in terms of altering function,orienting function,and executive control function.There was no statistically significant difference in the error rate of the left and right visual field reaction between the three groups in terms of altering function,orienting function,and executive control function.Study 2:The total alerting effect of the patients after stent placement was significantly higher than that before stent placement [t(39)=2.49,p <0.05];There was no significant difference in total orienting effect and total executive effect before and after stent implantation.Before stenting,the executive function of the left cerebral vascular stenosis patients had the advantage of the right visual field [t(19)=2.21,p <0.05],and there was no significant difference in their altering and orienting function between the two sides of the field of vision.After the stenosis intervention,there were no significant differences in the response time between the left and right visual fields in terms of altering network function,orienting network function,and executive control network function.Conclusions In the healthy control group and the right hemisphere acute cerebral infarction group,the left hemisphere was dominant in the orienting function.In the left hemisphere after acute infarction,the left hemisphere dominance disappeared in the orienting function,It is suggested that orienting function is injured during the left hemisphere infarction.Cerebral vascular stenosis can cause the changes in attentional lateralization while the original attentional lateralization changes after the stenosis intervention.The total altering function was increased after stenosis intervention.