A Clinical Study Of Relationship Between The Sleep Disorders And Cognitive Impairment After Acute Cerebral Infarction

Objective To explore the correlation between sleep disorder and cognitive function in patients with acute cerebral infarction of different parts and sides through PSQI,PSG and cognitive assessments. This study will provide related basis of the diagnosis, treatment and prognosis of sleep disorders and cognitive impairment for acute cerebral infarction.Methods 17 patients with different acute cerebral infarction in Department of Neurology in our hospital from July 2014 to January 2015 were selected as the case group, and 30 random patients without any neurological diseases and other physical diseases were selected as the control group. The group of acute cerebral infarction including the group of sleep disorder (n=12) and the group of non-sleep disorder (n=5). The case group including the group of single sleep disorder(n=12) and the normal group (n=18).Two groups assess the sleep function throug PSG. The Montreal Cognitive Assessment (MOCA) and Mini Mental State Examination (MMSE) was used for the general assessment of cognition, The Trail Making Test (TMT) for the assessment of visual-spatial function, the Wisconsin Card Sorting Test (WCST) for the assessment of executive function, Words Fluency Task (WFT) for the assessment of linguistic function,The Hamilton Depression Scale (HAMD), Modified Apathy Evaluation Scale (MAES) and Hamilton Anxiety Scale (HAMA) for the assessment of emotional function on the case group and control group. All data will be statistical analyzed by the SPSS 17.0 software.Results (1) Compared with the group of non-cerebral infarction, the group of cerebral infarction have the longer AT. The group of sleep disorder with cerebral infarction have the longer S1+S2, AHI and the shorter S3+S4, MSpO2 and LSpO2 than the normal group. Compared with the normal group, the group of single sleep disorder have the higher AHI and the shorter S3+S4. The group of the cortical infarction and the cerebellar infarction have the shorter S3+S4 than the group of subcortical infarction, brainstem infarction and multiple-side infarction.compared with the group of cortical infarction, the group of cerebellar infarction have the higher AHI and ODI. The group of multiple-side infarction have the longer AT than the group of brainstem infarction. The group of cerebellar infarction have the longer sleep latency than the group of multiple-side infarction (p<0.05).(2) Compared with the normal group, the group of cerebral infarction scored lower in MOCA, MMSE, directive force, visual-spatial function and RCP, RFP. And scored higher in HAMD, RE, RP and NRPE. Compared with the normal group, the group of sleep disorder, non-sleep disorder with cerebral infarction and single sleep disorder scored lower in MOCA and MMSE. The group of sleep disorder with cerebral infarction scored lower in the delayed memory than the normal group. And scored lower in directive force than the group of non-sleep disorder with cerebral infarction, single sleep disorder and the normal group. The group of sleep disorder with cerebral infarction scored higher in HAMD than the group of single sleep disorder and the normal group. the group of non -sleep disorder with cerebral infarction scored higher in the normal group. The group of sleep disorder with cerebral infarction scored higher in HAMA than the normal group. The group of sleep disorder with cerebral infarction scored in NRPE than the he group of single sleep disorder and the normal group (p<0.05).(3) The group of single sleep disorder:MOCA and MMSE was positively correlated with TST and SE. WFT was positively correlated with S3+S4. HAMA was positively correlated with AT and correlated with REM. MAES was positively correlated with S1+S2 and negatively correlated with REM (p<0.05). WCST(CC) was positively correlated with TST. WCST(RC) was positively correlated with S3+S4. WCST(RE) was negatively correlated with TST and SE. WCST(RFP) was positively correlated with TST. WCST(NRPE) was negatively correlated with TST and SE.WCST(L-L) was positively correlated with TST(p<0.05). The group of sleep disorde with cerebral infarction:MOCA and MMSE were positively correlated with TST and SE, and negatively correlated with AT. TMT was positively correlated with AT. WFT was positively correlated with TST and negatively correlated with AT. MAES was positively correlated with AT and negatively correlated with TST and SE. HAMD was positively correlated with AHI and negatively correlated with MSpO2. WCST (L-L) was positively correlated with TST and SE and negatively correlated with AT and AHI.WCST (NRPE) was negatively correlated with REM (p<0.05). Conclusions (1) The group of acute cerebral infarction have the longer awakening time. The group of single sleep disorder have the longer S1+S2, and shorter S3+S4. The group of sleep disorder with acute cerebral infarction have the longer S1+S2, AHI and ODI. and shorter S3+S4 and MSpO2 and LSpO2. The parts of acute cerebral infarction have the different influence on sleep architecture. There is no obvious correlation between sides and sleep disorders. (2) Acute cerebral infarction and sleep disorder can impair memory, executive function and emotional cognition. Acute cerebral infarction merged sleep disorders aggravated cognitive impairment. (3) Cognitive decline in patients with sleep disorder was correlated with sleep structure disorder, but acute cerebral infarction with sleep disorder was correlated with sleep structure disorder and hypoxemia.