The Effects Of Carotid Atherosclerosis On Cognitive Function And Attention Network Function In Patients With Ischemic Cerebrovascular Disease

Objective:Cognitive impairment is a common clinical performance in old people.Cognitive function is related with the structure and functional activity of brain,blood flow and distribution of cerebrum. Carotid atherosclerosis(CAS) is an important risk of ischemic cerebrovascular disease,recently,research had found that it's related with cognitive impairment,and the cognitive impairment may occur before the clinical symptoms appear.The experiment used color Doppler to detected the carotid artery in patients with ischemic cerebrovascular disease and assess their cognitive performance by MoCA and ANT in order to found the effect of carotid atherosclerosis on cognitive function and attention network function in patients with ischemic cerebrovascular disease and the characteristic of their cognitive impairment.The conclusion may provide a theoretical basis for clinical diagnosis,treatment and prevention cognitive impairment.Methods:Selected our hospital inpatient department of neurology patients with ischemic cerebrovascular disease as a case group of 93 case,selected 39 subjects without cerebrovascular disease and carotid atherosclerosis as control group,the two group were matched in age,gender and the level of education.Explained the experiment to the subject and obtained their consent.Both group were carried out carotid ultrasonography examination,their carotid artery IMT were recorded and calculated the plaque score.MoCA was used to assess their cognitive performance, recorded the total score and the sub-item scores.Do ANT on computer,collected the date of reaction time and the number of correct and error times,calculated for each patient's reaction time of alerting,orienting,excutive network, the average response time and accuracy with Microsoft office excel 2003,stored in a computer hard disk,then analysis the dates through SPSS 17.0.Results:We divided the case group into four groups by the carotid ultrasonography results:non-CAS group,mild CAS group,moderate CAS group and severe CAS group,39 case without carotid atherosclerosis and ischemic cerebrovascular disease subjects were compared with the case group.l.MoCA score:(1)The case group's total score, visuospatial/executive,attention,delayde recall scores were significantly lower than control group.(2)The inter-group comparison of the case group have statistical difference,total score have statistical difference in non-CAS group and other three group,and the difference also presence between mild CAS group and severe CAS group.The visuospatial/executive function have statistical difference in non-CAS group and other three group.The attention function have statistical difference in non-CAS group and moderate and severe CAS group,and the difference also presence between mild CAS group and severe CAS group.Non-CAS group's delayed recall and moderate and severe CAS group's have statistical difference.(3) Correlation analysis between MoCA and carotid atherosclerosis found that carotid atherosclerosis is negatively correlated with total score, visuospatial/executive,attention,delayde recall scores.2.ANT:(1)Case group's orienting network and executing network are lower than control group,the average reaction time of case group is longer than the control group,the accuracy of case group is less than the control group.(2)Comparison among case groups,mild,moderate and severe CAS group's orienting network,executing network and accuracy are lower than non-CAS.Mild CAS group and moderate CAS group have no statistical difference.Mild CAS group's orienting network, executing network and accuracy are lower than severe CAS group's. Severe CAS group's orienting network and accuracy are lower than moderate CAS group.3.Correlation analysis between ANT and carotid atherosclerosis found that carotid atherosclerosis is negatively correlated with orienting, executing and accuracy and positively correlated with average reaction time.Conclusion:1.Carotid atherosclerosis affects cognitive function of patients with ischemic cerebrovascular disease,main in executive,attention and delayed recall.2. Cognitive function of patients with ischemic cerebrovascular which affected by carotid atherosclerosis is related with the degree of carotid atherosclerosis,more serious of carotid atherosclerosis more obvious cognitive impairment.3. Carotid atherosclerosis may affect attention network of patients with ischemic cerebrovascular disease,main in orienting network and executing network and they are related with the degree of carotid atherosclerosis,but alerting function is regular.4.As a simple method of detecting attention network function,Attention Network Test can effectively evaluate ischemic cerebrovascular patients'attention network impariment which affected by carotid atherosclerosis. It can help diagnosis the cognitive impairment of patients with ischemic cerebrovascular disease and be an objective electrophysiology indicator of attention function impairment.