Analysis On The Correlation Between Ischemic White Matter Lesions And Cognitive Function, Plasma Levels Of Heat Shock Protein 70,Gait

Objective:To investigate the cognitive function impairment of patients with White Matter ischemic Lesions(WMIL) at different extent, and to analyze the correlation of plasma heat shock protein 70 levels with WMIL. Meanwhile, to investigate the gait parameters under single and dual task conditions in patients with White Matter ischemic Lesions(WMIL) at different extent, and to analyze the correlation of WMIL and cognitive function with gait dysfunction.Methods:According to MRI,75 WMIL patients were recruited for the present study, applied Fazekas rating scale to assess the extent of WMIL, and according to the score results classified the 75 patients into WMIL-mild group, WMIL-moderate group and WMIL-severe group. During the same period,40 cases in normal controls were recruited. All the subjects’cognitive performance were assessed using the Montreal Cognitive Assessment(MoCA); Using Footprints to assess the gait parameters under single and dual task conditions, when the subjects walk along a straight 10-m corridor at a freely chosen pace and cadence and in a well-lit, level ground and which is free of obstacles or visual/ auditory distractions. An enzyme-linked immunosorbent assay was applied to measure plasma levels of heat shock protein 70.Results:The scores of total MoCA, visual spatial, executive function and delayed memory ability in WMIL-mild, moderate and severe group were significantly lower than that in control group (P<0.01), the scores of attention and calculation in WMIL-severe group also lower than that in control group(P<0.05); Correlation analysis showed that the severity of WMIL had a negative correlations with the performance of MoCA(P<0.05); The plasma levels of heat shock protein 70 with WMIL in mild, moderate and severe group had significantly higher than that in the control group, difference had statistical significance (P=0.05).Correlation analysis showed that the severity of WMIL had a positive correlations with the levels of plasma heat shock protein 70(P<0.05). Compared with control group, under single task condition, WMIL in moderate and severe group have a shorter stride length, lower gait velocity, greater variability of step length and stride width, there have a statistically significant. WMIL in severe group have a broader stride width, there have a statistically significant.Under dual task condition, WMIL in mild, moderate and severe group have a shorter stride length, lower gait velocity, greater step length variability and greater stride width variability, difference had statistical significance(P<0.05); WMIL in moderate, severe group, have a broader stride width, difference had statistical significance(P<0.05). Compared with the single task condition, under dual task condition,WMIL in mild, moderate and severe group have a shorter stride length, lower gait velocity, a broader stride width, greater step length variability and greater stride width variability, difference had statistical significance. Under single and dual task condition, correlation analysis showed that stride length and gait velocity had negative correlations with WMIL Fazekas grade(P<0.05), and positive correlations with the total MoCA scores(P<0.05); Stride width, step length variability and stride width variability had positive correlations with WMIL Fazekas grade(P<0.05),and negative correlations with the total MoCA scores(P<0.05).Conclusion:Patients with WMIL undergo gait and cognitive impairment of different degree. The more severe the WMIL, the more severe the cognitive impairment and gait disorders will be. Under the dual task,10 meters walking tests may be benefit to detect the gait abnormalities and cognitive impairment in WMIL patients in early time. The plasma levels of heat shock protein 70 with WMIL in mild, moderate and severe group were significantly higher than that in the control group, it impled that the plasma heat shock protein 70 may play a role in the pathogenesis of WMIL.