Correlation Of High Signal Load And Location And Cognitive Function In Punctate White Matter

Objectives:This study aimed to validate the above study hypothesis,and further study whether different locations of punctate WMH could cause different subtype of cognitive dysfunction.Methods:Recruited 644 volunteers without stroke and clinical asymptomatic,scale and head MRI magnetic resonance evaluation,Clinical data of all patients were collected,including general demographic data such as gender,age,educational experience,blood biochemical examination items(blood sugar,total cholesterol,triglyceride,high-density lipoprotein,and low-density lipoprotein),and vascular risk factors(hypertension,diabetes mellitus,coronary heart disease,lacunar infarction,carotid atherosclerosis,respiratory function,smoking history,alcohol history,etc.).The neuropsychological test battery included the Beijing version of the Montreal Cognitive Assessment(Mo CA),Mini-mental State Examination(MMSE),Number Connection Tests A(NCT-A),and Digital Symbol Test(DST)scale.These scales were assessed by a neurologist trained with neuropsychological assessment.Results: As the total number of WMH increased,punctate WMH numbers was significantly associated with lower DST score(β,-0.012;95% confidence interval [CI],-0.019 to-0.005)and more performance time of NCT-A(-0.011;-0.118 to-0.004).When analyzed per category,the presence of each WMH group was significantly associat.When additional adjustment for age,gender,education and blood pressure,the presence of lager(> 22)WMH burden was significantly associated with lower DST scores,and the presence of numbers ≥8 WMH was significantly associated with more time performance on NCT-A test.Statistical significance remained for the association between more WMH and lower DST scores and more performance time of NCT-A after adjusting for other imaging markers of CSVD(including LI,CMBs,EPVS,and BA).In addition,age,SBP,and DBP are independent factors of total WMH affecting DST and NCT-A performance.In individuals with PWMH,the presence of PWMH was associated with the lower DST scores and more performance time of NCT-A.After adjusting for vascular risk factors(model II in table 3).After full adjustment for other variables,the presence of PWMH were only significantly associated with DST scores.In individuals with DWMH,,the results shown that the presence of DWMH was only associated with the performance time of NCT-A.(model I in table 4).After additionally adjusting for vascular risk factors and other imaging markers of CSVD,the associations attenuated marginally,but the presence of DWMH was still associated with performance time of NCT-A.Conclusion: the study shows that punctate WMH causes a certain degree of cognitive impairment that is associated with decreased cognitive function and information processing speed in asymptomatic populations,which is related to the total numbers of WMH and distributions.