Research Of Relationship Between Ischemic White Matter Lesions And Cognitive Impairment

Objective To investigate the impacts of ischemic white matter lesion of the patients in different extents and locations on cognitive function and its correlation.Methods Ninety patients with ischemic white matter lesion and thirty-five gender—matched healthy subjects were recruited from the Department of Neurology and those admitted to the Second Hospital of Lanzhou University from October2012to November2013. According to MRI, ninety patients with white matter lesion were first classified into3subgroups (deep white matter lesions、periventricular lesions and mixed regions) depending on the location, then were classified into3subgroups (mild、moderate、severe)depending on the degree. All participants underwent neuropsychological tests by using the Mini-Mental state Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The impact of different extents and locations of white matter lesion on cognitive function was assessed by statistical analysis.Results Compared with control group, WML in different degree groups had significantly lower scores in total MMSE and MoCA scores, visual spatial, executive function and delayed memory ability(P<0.05). In severe groups, the scores of MoCA individual cognitive components decreased significantly except the function of abstractions(P<0.05); Correlation analysis showed that the severity of WML had a negative correlations with the performance of MoCA and MMSE(r=-0.780,-0.817P<0.05). The scores of executive function and language in DWML group were lower than in PVL and control group(p<0.05). PVL group had significantly lower scores in delayed memory and attention compared with DWML and control groups(P<0.05). In mixed regions group, the scores of MoCA individual cognitive components decreased significantly except the functions of abstractions compared with control group(P<0.05).Conclusions The WML patients with small vessel disease undergo cognitive impairment of different degree. The more serious of white matter lesion, the more significant decline in cognitive function. PVL and DWML have different impacts on cognitive function.