| Background:Cognitive impairment associated with cerebral small vessel disease focuses on four common impact markers or global brain atrophy,without distinguishing between cortical and subcortical,to assess the association of a specific brain region.As a new marker,DMV is the hot spot of current research.Objective:Neuropsychological scales and visual assessment scales were used to study the relationship.between cortical atrophy,deep medullary vein visibility with cognitive function in patients with cerebral small vessel disease.Methods:A total of 69 patients with cerebral small vessel disease who were hospitalized in the Department of Neurology,The First Affiliated Hospital of Nanchang University from February 2020 to February 2022 and complained of cognitive decline were selected.The Beijing version of the MOCA scale was used to score cognitive function(0～30 points),and the sub-items(visuospatial and executive function,language,abstraction,recall,orientation,attention)were recorded,and the total score was divided into NCI group,MCI group,Mo CI group,SCI group.The extent of atrophy in frontal lobe,temporal lobe,parietal lobe,and occipital lobe were scored according to the Whole Brain Cortex Atrophy Scale(0～3 points),the medial temporal lobe atrophy was scored according to the Medial Temporal Lobe Atrophy Scale(0～4points).The visibility of deep brain medullary veins was scored according to a visual scale(0 ～ 3 points).To study the relationship between cortical atrophy,deep medullary vein visibility and cognitive function in patients with cerebral small vessel disease.Results:1.There were no significant differences in gender composition,age,the prevalence of hypertension,diabetes,hyperlipidemia,and the proportion of smoking patients,and years of education among the four groups of subjects.The global brain atrophy score,frontal lobe atrophy score,parietal lobe atrophy score,temporal lobe atrophy score,medial temporal lobe atrophy score,and occipital lobe atrophy score were different among the four groups.statistically significant(F =20.157,P < 0.001;H = 24.086,P < 0.001;H = 21.940,P < 0.001;H = 21.897,P < 0.001;H = 19.875,P< 0.001).The total DMV visibility score,frontal area DMV visibility score,parietal area DMV visibility score,and occipital area DMV visibility were different among the four groups with different CI groups,and the group with high CI degree had higher DMV visibility score(F = 14.383,P < 0.001;H = 24.152,P < 0.001;H =16.046,P = 0.001;F = 6.844,P < 0.001).2.The degree of frontal lobe atrophy was significantly negatively correlated with visuospatial and executive function,language function,abstract ability,recall function,orientation,attention,and naming ability,and there was statistical significance(F =4.303,P = 0.008,r =-0.353;H = 12.689,P = 0.005,r =-0.422;F = 6.265,P = 0.001,r =-0.450;H = 10.295,P = 0.016,r =-0.329;F = 8.010,P < 0.001,r =-0.497;F =7.064,P < 0.001,r =-0.461;F = 6.644,P = 0.001,r =-0.408).The degree of parietal lobe atrophy was significantly negatively correlated with visuospatial and executive function,language function,abstract ability,recall function,orientation,attention and naming function,and there were statistical differences(F = 3.336,P = 0.025,r =-0.356;F = 4.345,P = 0.007,r =-0.355;H = 18.426,P < 0.001,r =-0.474;H = 9.697,P = 0.021,r =-0.287;F = 7.486,P < 0.001,r =-0.409;F = 5.292,P = 0.003,r =-0.407;F = 9.345,P < 0.001,r =-0.428).The degree of atrophy of the temporal lobe was significantly negatively correlated with language function,recall function,orientation ability,and attention,and it was statistically significant(F = 3.089,P =0.033,r =-0.345;F = 4.276,P = 0.008,r =-0.401;H = 12.782,P = 0.005,r =-0.414;F = 4.780,P = 0.005,r =-0.426).The degree of atrophy of the medial temporal lobe was significantly negatively correlated with language function,abstract ability,recall function,orientation and attention,and there were statistical differences(H = 12.669,P = 0.013,r =-0.389;F = 2.532,P = 0.049,r =-0.303;F = 2.547,P = 0.048,r =-0.366;F = 6.648,P < 0.001,r =-0.511;F = 4.844,P = 0.002,r =-0.483).3.The visibility of frontal lobe DMV was significantly negatively correlated with visuospatial and executive function,language function,abstract ability,recall function,orientation,attention,naming function,and it was statistically significant(F= 5.646,P = 0.005,r =-0.444;H = 12.256,P = 0.002,r =-0.470;F = 11.346,P <0.001,r =-0.534;F = 5.765,P = 0.005,r =-0.434;F = 5.492,P = 5.492,r =-0.405;F= 10.677,P < 0.001,r =-0.512;F = 3.492,P = 0.036,r =-0.361).The visibility of parietal DMV was significantly negatively correlated with visuospatial and executive function,language function,abstract ability,recall function,and attention(F = 4.887,P = 0.010,r =-0.376;H = 6.083,P = 0.048,r =-0.291;F = 4.465,P = 0.015,r =-0.377;F = 6.818,P = 0.002,r =-0.460;F = 6.114,P = 0.004,r =-0.389).The visibility of DMV in the occipital area was significantly negatively correlated with visuospatial and executive function,language function,abstract ability,recall function,orientation,attention,naming function(F = 3.934,P = 0.024,r =-0.309;F = 5.087,P= 0.009,r =-0.358;F = 9.619,P < 0.001,r =-0.430;F = 4.371,P = 0.016,r =-0.303;F = 3.001,P = 0.047,r =-0.346;F = 5.092,P = 0.009,r =-0.336;F = 4.189,P =0.019,r =-0.327).Conclusion:1.Atrophy of frontal,parietal,temporal,and medial temporal lobes was significantly negatively correlated with cognitive impairment in CSVD.DMV visibility in frontal,parietal,and occipital regions was significantly negatively correlated with cognitive impairment in CSVD.2.Frontal lobe atrophy and parietal lobe atrophy were significantly negatively correlated with visuospatial and executive function,language function,abstract ability,recall function,orientation,attention,and naming function;temporal lobe atrophy was significantly negatively correlated with language function,recall function,and orientation,attention were significantly negatively correlated;the degree of atrophy of the medial temporal lobe was significantly negatively correlated with language function,abstract ability,recall function,orientation,and attention.3.DMV visibility in frontal area and occipital area DMV visibility were significantly negatively correlated with the levels of visuospatial and executive function,language function,abstract ability,recall function,orientation,attention,and naming ability;Visual space was significantly negatively correlated with executive function,language function,abstract ability,recall function,attention function. |
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