Study Of Cognitive Function In Patients With Asymptomatic Unilateral Middle Cerebral Artery Stenosis Or Occlusion

Objective:To analyze and discuss the changes of cognitive function for asymptomatic unilateral middle cerebral artery stenosis or occlusive patients,which provide clinical evidences for the early detection of vascular cognitive impairment no dementia to diagnose, treat and improve the prognosis. Methods:62 patients with asymptomatic unilateral middle cerebral artery stenosis and with "the symptoms about headache, dizziness, fatigue, etc" treated in Bethune First Hospital of Jilin University from July 2015 to January 2016 and 44 normal controls were analyzed. The evolution results of clinical data, MMSE and Mo CA about the participants were registered. According to the test results, the subjects were divided into non-MCA stenosis group(controls group) and unilateral MCA stenosis group(patients group), wherein unilateral MCA stenosis group was divided into the left MCA(LMCA) stenosis and the right MCA(RMCA) stenosis; mild to moderate MCA stenosis group, severe MCA stenosis and occlusion group. Software SPSS 22.0 was used for statistical analysis. Results:1)Compared the Clinical data of Stenosis group and controls group:Age, sex, BMI, years of schooling,hypertension, diabetes, heart disease, hyperlipidemia,smoki-ng,alcohol consumption with the similar results which did not show statistically significance.2)Compared the MMSE total score and the cognitive domain scores of the patients between stenosis group and controls group:(1) The differences between stenosis group and controls group of the MMSE total score showed statistically significance(P <0.05);(2) The differences among the three groups LMCA stenosis group, RMCA stenosis group and the controls group of the MMSE total score showed statistically significant(P <0.05). But the difference between LMCA stenosis group and RMCA stenosis group showed no statistically significance;The differences among the mild to moderate MCA stenosis, severe stenosis and occlusion group and controls group of the MMSE total score showed statistically significant(P <0.05). But the differences between mild to moderate MCA stenosis group and severe MCA stenosis and occlusion group showed no statistically significance.(3)The differences between stenosis group and controls group in the ability of orientation, calculation, language, structure imitating which belong to MMSE cognitive domain showed statistically significance(P <0.05). The differences of the ability of orientation, language and structure imitating showed statistically significance by comparing MMSE cognitive domain among different sides of stenosis group and controls group(P <0.05). The differences of scores in left and right sides of stenosis group by comparing all cognitive domains showed no statistically significance; The differences of the ability of orientation and language showed statistically significance by comparing MMSE cognitive domain between the different degrees stenosis group and controls group(P <0.05); But there is no statistically significance by comparing the differences of all cognitive domains in mild to moderate MCA stenosis group and severe MCA stenosis and occlusion group.3) Compared the Mo CA total score and the cognitive domain scores of the patients between stenosis group and controls group:(1) The differences between stenosis group and controls group of the Mo CA total score showed statistically significance(P <0.05);(2) The differences among the three groups LMCA stenosis group, RMCA stenosis group and the controls group of the Mo CA total score showed statistically significant(P <0.05). But the difference between LMCA stenosis group and RMCA stenosis group showed no statistically significance;The differences among the mild to moderate MCA stenosis, severe stenosis and occlusion group and controls group of the Mo CA total score showed statistically significant(P <0.05);But the differences between mild to moderate MCA stenosis group and severe MCA stenosis and occlusion group showed no statistically significance;(3)The differences in visual-spatial/executive function, attention, language ability, memory latency which belong to Mo CA cognition domain showed statistically significance(P <0.05); The differences in visual-spatial/executive function, language ability, memory latency and abstract ability showed statistically significance(P <0.05); But only the difference of abstract ability showed statistically significance between left and right sides of stenosis group(P <0.05); The differences of Visual-spatial/executive function, attention and language ability showed statistically significance by comparing Mo CA cognition domain(P <0.05); But there is no statistically significance by comparing the differences of all cognitive domains in mild to moderate MCA stenosis group and severe MCA stenosis and occlusion group.4) Compared the positive rate of cognitive impairment in the left and right stenosis groups and the different degrees stenosis groups:The positive rate of cognitive impairment in patients with LMCA stenosis was higher than that in the RMCA group, but there was no significant difference in the positive rate between the mild and moderate MCA stenosis group and the severe stenosis and occlusion group Conclusion:1.Asymptomatic unilateral MCA stenosis is the independent risk factor for mild cognitive dysfunction. It is beneficial to patients through timely intervention.2.Asymptomatic unilateral MCA stenosis patients exist mild cognitive impairment which mainly represent visual-spatial/executive function, attention, language ability, memory latency and calculation ability, etc. But there is no significant difference between the left and right sides and different degrees of stenosis group(P> 0.05).3. The positive rate of cognitive impairment in patients with LMCA stenosis was higher than that in the RMCA group, but there was no significant difference in the positive rate between the mild and moderate MCA stenosis group and the severe stenosis and occlusion group.