The Preliminary Research On The Characteristics Of The Cognitive Function And The Mechanism In Frontal Bottom Laceration Patients.

Objective:Firstly, we analyse the characteristics of the cognitive function in unilateral frontal bottom laceration patients after one month from neural physiological and psychological perspective.Secondly, we explore that how do Brain-derived neurotrophic factor (BDNF) and neurotransmitters Ach play the role in the cognitive dysfunction pathophysiological mechanisms from molecular biology perspective.Thirdly, through analysing the characteristics of the cognitive function in unilateral frontal bottom laceration patients who carry the different phenotypes of BDNF Val66Met from Genetical perspective,we speculate that BDNF Val66Met maybe one of the risk genes in the recovery of the cognitive function.Lastly,we explore the correlation between the cognitive function and the age, gender, occupation, treatment----surgery or conservative treatment, and the education level.Methods:Firstly, using four scales, including MMSE, LOTCA, MoCA, WCST,evaluate neurocognitie function in 62 patients group and 66 cases of normal controls after one month.Secondly,applying the cognitive potential instrument measures the wave amplitude and the latency of the endogenous composition N2,P3 of P300.Thirdly,using the technology of ELISA determines the lever of AchE and BDNF.Using the way of Ration measures the active of AchE and using the way of PCR/RFLP analyses BDNF Val66Met gene polymorphism.Lastly,we use the way of multivariate stepwise regression to analy the correlation between the overall cognitive function and the lever and active of AchE,. the lever of the BDNF, BDNF Val66Met, the age, gender, occupation, treatment----surgery or conservative treatment and the education level. we also use the way of linear regression to analy the correlation between the lever of AchE and the lever of BDNF.Results:Firstly, the cognitive test scores in patients ground are significantly worse than normal controls in the same case. The latency of the endogenous composition N2,P3 in patients than the normal controls(p=0.001; p=0.002) and the wave amplitude is lower(p= 0.043;p=0.024). The differences of the active of AchE in patients have not statistical significance in the the normal control team(p= 0.821),however,the lever of AchE and BDNF have statistical significance(p= 0.027; p= 0.000).Secondly,the ability of retell sentences., the fluency of words, reading,understanding lauguage, cognitive transfering decreases in the left frontal bottom laceration patients(Group A),while the ability of attention, calculating, action, organization,graphics depicting , abstract epitoming, logical thinking goes down in the right frontal bottom laceration patients(Group B). The latency of N2,P3 in Group A of is more lengthen than Group B(p=0.016;p=0.000),while the wave amplitude is higher(p=0.0043;p=0.029).The differences of the active of AchE, the lever of AchE and BDNF have not statistical significance between Group A and Group B patients(P>0.05).Thirdly,the distribution of the gene and equal gene are fit to the law of the Hardy-Weinberg.This means that the trial team has the representativeness. The cognitive test scores in Val /Met patients ground are significantly worse than the other subtypes of the Val66Met gene polymorphism in the same case(P<0.05).The characteristics of the cognitive function of the subtypes of the Val66Met gene polymorphism are different. The performance is that the ability of graphic depiction, the fluency of words, abstract epitoming and delayed recall declines in Val/Val gene subtype,while the ability of attention, calculating, cognitive transferring, logical thinking damages in Val/Met gene subtype ; action, organization, retell sentences,reading and understanding, logical thinking, in Met/Met gene subtype. The latency of the frontal bottom laceration patientsBDNF Val /Met is more lengthen than the other subtypes of the Val66Met gene polymorphism patients(p=0.021;p=0.000〕, and the wave amplitude of the frontal bottom laceration patients BDNFMet/Met is lower than the other subtypes of the Val66Met gene polymorphism patients(p=0.037; p=0.001). The differences of the active of AchE, the lever of AchE and BDNF have not statistical significance in the three subtypes of the Val66Met gene polymorphism(P>0.05).The correlation of the overall cognitive function has the linear regression with the parts of the brain and the lever of AchE and BDNF , BDNF Val66Met ,age, gender, occupation, treatment----surgery or conservative treatment, and the education level.The standardized and partial regression coefficients showed the lever of AchE and BDNF, BDNF Val66Met,have the biggest influence to the overall cognitive function. (∣Beta∣7=0.8891,∣Beta∣8=0.6654,∣Beta∣9=0.9601, r7=0.8798r8=0.679,r9=0.9123). The correlation between the lever of AchE and the lever of BDNF have linear regression(r=0.817).Conclusions:Firstly,the ability of the cognitive function is worse than normal control in frontal bottom laceration patients in unilateral frontal bottom laceration patients after one month.Secondly,.the specific performance of cognitive function in unilateral frontal bottom laceration patients closely related with the parts of the injuried frontal bottom laceration.and the BDNF Val66Met. The BDNF Val66Met polymorphism maybe one of the genetic factors in the cognitive function after frontal lobe laceration.Thirdly,Brain-derived neurotrophic factor (BDNF) and neurotransmitters Ach maybe play the role in the cognitive dysfunction pathophysiological mechanisms.Lastly,the cognitive function is also influented by the age, gender, occupation, treatment--surgery or conservative treatment, and the education level.The ordinal degree is that the education level, treatment---surgery or conservative treatment, occupation, gender , age.