Association Between Multiple Lacunar Infarction, White Matter Lesion And Vascular Dementia

Objective:To explore the relationship between small vessel disease(SVD) and vascular dementia(VD). Ischemic SVD includes both multiple lacunar infarction(MLI) and white matter lesion(WML). In order to provide basement on prevention, early diagnosis and intervention of VD.Methods:The patients in neurology department of90cases of SVD in the People’s Hospital of Ning xia Autonomy from April2010to April2011, who were in line with the1995Fourth National Symposiumon Cerebrovascular Diseases revised diagnostic criteria. Recorded the smoking, alcohol using of the patients and whether they had the history of hyperlipidemia, hypertension, diabete, neuropsychology scale such as Hachinski Ischemic Index(HIS), Hamilton Depression Rating Scale(HAMD) were applied to evaluate of patients. These90patients with small vessel disease(SVD) according to MRI or CT images were divided into pure MLI group(35cases), both MLI and WML group(31cases),pure WML group (24cases) and normal person as control group(23cases) by MMSE scores and MoCA scores after SVD3months.Results:(1) MoCA in Pure MLI group, MLI+WML group and pure WML group were respectively (22.40±6.83)、(21.35±5.55)及 (26.41≈3.48)。MMSE were respectively (24.20±6.07)、(24.11±4.95)及(26.91±3.02).Pure MLI group, MLI+WML group, pure WML group MoCA and MMSE totle seores are positive correlation (r=0.895,p=0.000; r=0.761,p=0.000; r=0.932,p=0.000)(2) Among MMSE scores, immediate memory, short memory,object naming, language repeat,reading comprehension, verbal exposition of pure MLI group are lower than control group(P <0.05). Temporal orientation, short memory, language repeat of group with both MLI and WML are lower than control group(P<0.05). All subitems scores had not significant difference between pure WML group and control group(P>0.05). The score of reading comprehension in pure MLI group is lower than group with both MLI and WML(P<0.05).(3)Number of people in pure MLI、group with both MLI and WML、pure WML had significant difference among VD at different extent(P<0.05)(4). Infarcted had not significant difference between pure MLI and group with both MLI and WML(P>0.05)(5)Pure WML and control group logistic regression hypertension and diabetes are related to WML, hypertension influence WML at some extent.Conclusion:Pure MLI group, MLI+WML group, pure WML group MoCA and MMSE totle seores are Correlated.In three groups, both MLI and WML group are easiest to lead to VD. Ischemic SVD, especially pure MLI can lead to VCI, wich show in temporal orientation, place orientation immediate memory and so on. The pure WML damage cognitive ability is not clear, but WML may be affected dementia. Hypertension is the most important risk of VD...