Correlation Analysis Between Imaging Features And Cognitive Impairment In Patients With Ischemic Cerebral Small Vessel Disease

Objectives Cerebral small vessel disease is the most common type of vascular cognitive impairment, and it is also a kind of cerebrovascular disease which was payed more and more attention in recent years. This study was conducted to investigate the correlation between imaging changes and cognitive impairment in patients with ischemic cerebral small vessel disease in Tangshan Workers’ Hospital by imaging and neuropsychological tests。Methods 155 cases of patients with cerebral small vessal disease admitted to Neurology Department of Tangshan Workers’ Hospital during January 2015 to December 2015 were enrolled in this study, which head MRI performance of lacunar infarction and leukoaraiosis. According to the cognitive function examination 29 patients were excluded with dementia. Among the 126 patients left, 80 patients of VCIND group and 46 patients of NCI group. Clinical data were collected, such as: age, gender, educational level,history of hypertension, diabetes mellitus,hyperlipidemia, etc. The number and location of LI lesions were recorded according to the head MRI. Fazekas scale was used to score the level of leukoaraiosis and the volume of leukoaraiosis was calculated by the Image J1.40 bundled with Java 1.6.0₀5 software. Analysis of two groups of patients with MRI features and the correlation of cognitive impairment.Results 1 Neuropsychological tests showed that the Mo CA scores of the VCIND group was statistically significantly lower than that of the NCI group（P<0.001）. In naming,attention, language, abstraction and directional force, Mo CA scores of the two groups showed no significant difference（P>0.05）. In visual spatial and executive ability and memory, VCIND group MOCA scores were lower than the NCI group, the difference has statistical significance（P<0.001）. 2 VCIND group connection test（P=0.002）, frontal function evaluation（P<0.001）, picture clock test（P<0.001）, Stroop color word test A（P=0.045）, B（P<0.001）, C（P=0.002） were statistically significant. 3 The total number of LI in group VCIND is higher than that in NCI group. LI lesion number in frontal lobe（P=0.027）, basal ganglia（P=0.030） and infratentorial area（P=0.002） are significantly bigger in VCIND group than in NCI group, while there are no significant significance in parietal occipital lobe（P=0.705） and temporal lobe（P=0.601）. The number of LI in group VCIND was 4.44. 4 The standard coefficient of LI in basal ganglia region was 1.971,which was greater than the standard coefficient of LI in subcortical-1.241. 5 The severity of LA in CSVD patients was negatively correlated with Mo CA scores. 6 The volume of LA was positively correlated with the Fazekas score.Conclusions 1 CSVD patients with cognitive impairment is mainly manifested in the visual spatial and executive ability. 2 The degree of VCI increased with the increase of the number of LI lesions,the severity of LA lesions and the lesion volume. 3 When the number of LI is more than 4, the risk of occurrence of VCI is higher. 4 Basal ganglia region LI is more likely to result in VCI than subcortical LI.