Relationship Between Vascular Stenosis And Cognition Impairment In Patients With Leukoaraiosis

Background and Objective Leukoaraiosis is paid a close attention gradually with the developing of radiology and aged tendency of population. LA is not only related to the decline of cognitive function, but also an independent risk factor of stroke. Although LA is always thought that it is resulted in small vessel disease, but more researches show that large vessel stenosis is another significant factor in recent years. The patients with LA suffered from the impairment of multi-field cognitive function, which mainly reflected as the damage of executive and attention function. However, there is few reports covered the relation between these impairment and the large vessel stenosis. This report will evaluate the degree of leukoaraiosis and the extent of vascular stenosis, which aimed to explore the relationship between the degree of vascular stenosis and cognition in leukoaraiosis patients.Materials and Methods A total of 101 leukoaraiosis patients from the Department of Neurology, The First Affiliated Hospital of Anhui Medical University between September 2013 and June 2014, divided into two groups: patients with cognitive impairment(SVCI)(n=54) and those without cognitive impairment(NC)(n=47). All patients were enrolled and examined by magnetic resonance imaging(MRI) scanning and magnetic resonance angiography(MRA) or computed tomography angiography(CTA). The cognitive assessments were made by MMSE(mini-mental state examination), CAMCOG-C(Cambridge cognitive examination-Chinese version) and CDR(clinical dementia rating). The severity of leukoaraiosis and vascular stenosis was graded by MRI and MRA/CTA scans.Results The degree of vascular stenosis group and the severity of LA in SVCI were significantly higher than NC(2.0±0.8 vs.1.1±0.6, 2.6±1.0 vs.2.0±1.0; P=0.020, P=0.003). As white matter level aggravated, cognitive function decreased and vascular stenosis deteriorated accordingly,and the score of MMSE(25±4, 24±6, 22±4) and CAMCOG-C(83±14, 80±14, 73±14)has a statistical significance(P=0.012, P=0.014). At the same time, the negative correlation was found in LA patients between cognitive function and severity of LA(r=-0.317, P=0.317) as well as degree of vascular stenosis(r=-0.284, P=0.284). Multivariate logistic regression analysis revealed that, after controlling for various factors, both severity of LA(OR=2.025, 95% CI=2.025-3.954) and the degree of vascular stenosis(OR=1.812, 95% CI=1.812-2.908) were risk factors for cognitive impairment in leukoaraiosis patients.Conclusions Both vascular stenosis and leukoaraiosis are considered to be strongly linked with cognitive impairment. Vascular stenosis with other factors could contribute to white matter lesion while the vascular stenosis itself may lead to cognition dysfunction. Thus, to intervene the vascular disorder at early stage will be beneficial to relieve the burden of white matter lesion, even to improve the cognition in the future, which providing us a new insight to prevent vascular dementia.