Research On Cognitive Function Impairment,Lesion Location And Influencing Factors Of White Matter Hyperintensity

Objective: White matter hyperintensities(WMH)are a common pathological manifestation of cerebral small vessel disease.They are typically classified into two types: periventricular white matter lesions(PWML)and subcortical white matter lesions(DWML).WMH is closely linked to cognitive function.Limited research has been conducted on the correlation between the placement of white matter lesions and cognitive abilities.Furthermore,the root cause of cognitive decline resulting from white matter lesions remains uncertain.The aim of this study is to investigate the variations in Mo CA total scores and cognitive domains between patients with white matter damage in cerebral small vessel disease,specifically in the periventricular and subcortical groups.Additionally,the study aims to identify the related risk factors in patients with cognitive impairment in white matter disease and explore the possible mechanisms causing the disease.Methods: In this study,the clinical data of people aged 50 years and older who met the diagnostic criteria of WMH by cranial MRI in patients who visited the Department of Neurology of Qinhuangdao first hospital from December 2021 to October 2022 were studied,they were divided into pwmh and dwmh groups according to the location of the lesion,MOCA scores were performed in the two groups,the general data of the two groups and the scores of each cognitive domain were analyzed,and Statistics were made on whether there were statistical differences between the two groups in each score.After further dividing them into cognitively normal and cognitively impaired groups according to the MOCA score,we investigated whether the general and serological data were statistically different between the two groups,and finally analyzed the related influencing factors of cognitive impairment in cerebral small vessel disease white matter damage by logistic regression.Results:1.Compared with the DWMH group,the Mo CA total score,executive function score,calculation power score,and orientation score in the PWMH group were all lower,and the difference between the two groups was statistically significant(P<0.05).2.Compared with the WMH cognitively normal group,the WMH cognitively impaired group had higher uric acid levels,homocysteine levels,and a higher proportion of hypertension prevalence,with statistically significant differences between the two groups(P < 0.05).After multivariate regression adjusted for age,sex,the results suggested that only the history of hypertension and the level of uric acid were significantly higher in the cognitive impairment group with WMH than in the cognitively normal group(P < 0.05).Conclusion: 1.The cognitive difference between PWMH group and DWMH group is mainly reflected in the executive function,computing power,orientation and Mo CA total score,and the cognitive decline in PWMH group is more obvious.2.After adjustment for age and sex effects,hypertension and uric acid were found to be risk factors for cognitive impairment in white matter lesions.