Cerebral Perfusion Changes In Patients With Vascular Cognitive Impairment

Aim To explore the risk factors of vascular cognitive impairment(VCI)and investigate the cerebral perfusion changes in patients with VCI.Methods Patients diagnosed with acute ischemic stroke in the memory disorders clinic were enrolled.Neuropsychological scale evaluation and cranial MR examination(including dynamic susceptibility contrast enhanced scanning)were performed by these patients 3 months after the onset of the stroke.According to the scales results,they were divided into normal cognition group(control group),non-dementia vascular cognitive impairment(VCIND)group and vascular dementia(Va D)group.Information including clinical data and cerebral perfusion of frontal lobe,temporal lobe,parietal lobe,hippocampus and posterior cingulate gyrus was evaluated among the three groups.Results In this study,30 cases were included in the control group,21 cases were included in the VCIND group and 21 cases were included in the Va D group.The level of glycosylated hemoglobin(Hb A1c)and white matter lesions in the control group were lower than that in VCIND group and Va D group(P<0.05).Hb A1 c and white matter lesions were independent risk factors for VCI(P<0.05).In the VCIND group,mean transit time(MTT)value of the right frontal lobe and the right temporal lobe were higher than that in the control group(P<0.05),time to peak(TTP)value of the posterior cingulate gyrus was higher than that in the control group(P<0.05).In the Va D group,MTT value of bilateral frontal lobe,right temporal lobe,left parietal lobe and bilateral posterior cingulate gyrus were higher than that in the control group and VCIND group(P<0.05).In the Va D group,TTP and MTT value of bilateral hippocampal were higher than those in control group(P<0.05),the value of relative cerebral blood flow and relative cerebral blood volume of left temporal lobe,left parietal lobe and bilateral hippocampal were lower than those in the control group(P<0.05).Conclusion High level of Hb A1 c and white matter lesions were independent risk factors for VCI.Patients with VCI had decreased cerebral perfusion.In the early stage of VCI,mild cerebral hypoperfusion was found in the frontal lobe,temporal lobe and parietal lobe.As the disease progressed,the degree of hypoperfusion was serious and other brain regions including hippocampus were included.