Study On The Correlation Between Total MRI Burden And Cognitive Function In Patients With Cerebral Small Vessel Disease

Objective:To explore the correlation between the total MRI burden and the general cognition and cognitive domain function of patients with cerebral small vessel disease,and to study whether the changes of cerebral microbleeds and lacunes will affect the general cognitive function of patients with cerebral small vessel disease.Method:We collected general baseline data of 80 patients with cerebral small vessel disease,the data include age,sex,years of education,hypertension,diabetes,ischemic heart disease,atrial fibrillation,previous stroke / TIA(transient ischemic attack)history,hyperlipidemia,smoking history and drinking history.According to the total MRI burden scores of cerebral small vessel disease,the patients were divided into 5groups according to the score of 0-4.The total MRI burden includes four kinds of MRI findings: cerebral microbleeds,lacunes,white matter hyperintensities and enlarged perivascular spaces,whichever can be recorded as 1 point.After categorizing,we evaluated the general cognition and cognitive domains of the five groups respectively.The general cognitive evaluating scales include Mini-Mental State Examination(MMSE)scales and Montreal Cognitive Assessment(Mo CA)scales.The evaluation of each cognitive domains include memory(Rey auditory verbal learning test,RAVLT),attention/executive function(digit span test,DST;trail making test,TMT;Stroop color-word test,CWT),information processing speed(symbol digit modalities test,SDMT),visual spatial structure function(block design,BD)and language(Boston naming test,BNT;verbal fluency test,VFT).After completing these assessments,we try to explore the correlation between total MRI burden scores and the general cognition and cognitive domain function in patients with cerebral small vessel disease.Additionally,we divided 80 patients with cerebral small vessel disease into some groups according to the number of microbleeds and lacunes.According to the number of microbleeds,the patients were divided into 4 groups(0,1-5,6-10 and >10),we also divided patients into 3 groups(0,1 and >1)according to the number of lacunes.And then,we explore the correlation between the number of microbleeds and lacunes and the general cognitive function of patients with cerebral small vessel disease.Results:1.In subgroups of MRI total burden scores:(1)There were statistically differences in age,ischemic heart disease,previous stroke or TIA history among the five groups(P < 0.05).There was no statistically difference in gender,years of education,hypertension,hyperlipidemia,diabetes,atrial fibrillation,smoking and drinking(P>0.05).(2)In aspects of general cognitive function scores with five groups:There was statistical difference in the scores of MMSE and Mo CA(P<0.05),and the total MRI burden scores were negatively correlated with MMSE(r=-0.342,P=0.002)and Mo CA scores(r=-0.336,P=0.002).(3)In aspects of cognitive domain scores with five groups:There were statistical differences in Rey auditory verbal learning test,Stroop color-word test(Part C),the time of Stroop interference effects(SIE),symbol digit modalities test and Semantic fluency test(P<0.05).There was no statistical difference in digit span test,trail making test(Part A),Stroop color-word test(Part A and B),the accuracy of Stroop interference effects,block design,Boston naming test,pronouncing fluency test and moving fluency test.(P>0.05)In aspects of memory,the total burden MRI scores were negatively correlated with immediate memory(r=-0.359,P=0.001)and delayed recall(r=-0.302,P=0.007).In aspects of attention/execution,the total burden MRI scores were positively correlated with the time of Stroop color-word test(Part C)(r=0.511,P=0.000)and the time of SIE(r=0.420,P=0.001).In aspects of information processing speed,the total burden MRI scores were negatively correlated with the symbol digit modalities test(r=-0.346,P=0.002).In aspects of language,the total burden MRI scores were negatively correlated with semantic fluency test(r=-0.386,P=0.000).2.The number of microbleeds in subgroups:There was statistical difference in the number of cerebral microbleeds and the scores of MMSE and Mo CA scales(P <0.05).There was a negative correlation between the number of cerebral microbleeds and the Mo CA scores(r=-0.266,P=0.017).However,the correlation between the number of cerebral microbleeds and the MMSE scores was no statistical meaning(P>0.05).3.The number of lacunes in subgroups:There was no statistical difference in the number of lacunes and the scores of MMSE and Mo CA scales(P > 0.05).The correlation between the number of lacunes and the scores of MMSE and Mo CA scales was no statistical meaning(P>0.05).Conclusions:With the increase of total MRI burden in patients with cerebral small vessel disease,the general cognitive function,memory,attention/execution,information processing speed and language function will decrease.Among the total MRI burden,the number of cerebral microbleeds is also a risk factor affecting the general cognitive function.The weight of cerebral microbleeds counts might have a certain influence on the assessment of general cognitive function by total MRI burden,which should be considered in the evaluation of cognitive function.