Early Diagnosis And Follow-up Study Of 200 Cases Of Vascular Cognitive Impairment After Acute Cerebral Infarction

Background: The prevalence of vascular cognitive impairment(VCI)was increased gradually as the population ages and cardiovascular disease survival improves.Among them,the cognitive impairment after acute cerebral infarction was a hot area of research in recent years.There were no the early diagnostic criteria and the assessment tools for VCI because the clinical manifestations of the VCI were varied and the assessment tools had their own advantages and disadvantages at home and abroad.There were different degrees of false positive or false negative rates.Only the VCI could be made early diagnosis,prevention and treatment,it would be delayed or prevented to vascular dementia.It was important to the whole society.Objective: ⑴To compare the value of MoCA scale,MMSE scale,ERP-P300 latency period and ERP-P300 amplitude in the early diagnosis of cognitive impairment in patients after acute cerebral infarction.⑵To observe the changes in the results of MoCA scale,ERP-P300 latency period and ERP-P300 amplitude in patients of the vascular cognitive impairment no dementia(VCIND)group in the different times in the follow-up study.Methods: ⑴200 cases of inpatients with acute cerebral infarction were assessed with MoCA scale,MMSE scale,ERP-P300 latency period and ERP-P300 amplitude.The positive rates were observed and compared with each other.Further,the positive rate of using MoCA scale and ERP-P300(inculding ERP-P300 latency period and ERP-P300 amplitude)together was higher than one of the three.Last,the patients were divided into no cognitive impairment(NCI)group,VCIND group,and vascular dementia(VaD)group based on the clinical dementia rating(CDR).Then the three groups were compared with each other.⑵The patients of VCIND group were followed in 30 days,90 days and 180 days.At the same time,the patients did MoCA scale,ERP-P300 latency period and ERP-P300 amplitude tests again.Then,the changes in the results of MoCA scale,ERP-P300 latency period and ERP-P300 amplitude tests were observed and analyzed.Results: ⑴In the screening of cognitive impairment after acute cerebral infarction,the positive rates of MoCA scale(45.0%)and ERP-P300 latency period(39.5%)were higher than MMSE scale(26.5%)and ERP-P300 amplitude(29.5%).There were statistically significant(p<0.05).⑵The positive rate of using MoCA scale and ERP-P300(inculding ERP-P300 latency period and ERP-P300 amplitude)together(62.0%)was higher than MoCA scale(45.0%),ERP-P300 latency period(39.5%)and ERP-P300 amplitude(29.5%).There were statistically significant(p<0.05).⑶The comparisons of MoCA scale,MMSE scale,ERP-P300 latency period and ERP-P300 amplitude in the three groups were all statistical significant(p<0.05).⑷The improvement rate of VCIND group in 14 days,30 days,90 days and 180 days were 0%,11.9%,61.9%,and 64.3%.Besides,the comparison of the results of MoCA scale,ERP-P300 latency period and ERP-P300 amplitude between 14 days and 30 days weren’t statistically significant(p>0.05).The comparison of the results between 90 days and 180 days weren’ statistically significant too(p>0.05).The comparisons of the other two were statistically significant(p<0.05).Conclusions: ⑴The MoCA scale,MMSE scale,ERP-P300 latency period and ERP-P300 amplitude all could be used as an early diagnostic tools to the VCI after acute cerebral infarction.But,the MoCA and ERP-P300 latency period were more sensitive.⑵ In the early diagnosis of VCI,the results suggest that MoCA scale and ERP-P300 should be used together.⑶ The follow-up study was shown that about 60% impairments could be recovered in VCNID group.In addition,the main recovery time was within 90 days.The changes of cognitive function could be assessed and predicted by ERP-P300 in follow-up study.