Neuropsychological Characteristics Of Cognitive Impairments Associated With Occipital Periventricular Leukoaraiosis

BACKGROUND & OBJECTIVEWith the extensive application of computed tomography(CT)and magnetic resonance imaging(MRI),leukoaraiosis(LA)is increasingly found in middle-aged and elderly people.At present,a large number of studies have shown that LA was connected with cognitive impairment,whether directly lead to cognitive impairment or by cortical atrophy mediated,and it was generally considered as independent risk factor of vascular dementia and Alzheimer's disease.However,whether early localized white matter lesions(solitary semi-oval region,lateral ventricle anterior horn,posterior or parietal leukoporosis)caused damage to cognitive function,and the characteristics of cognitive impairment caused by different parts of white matter lessions was still not clear.so this study choose subjects with common,early,focal leukoaraiosis-solitary occipital periventricular leukoaraiosis(OPVL)for the study,to explore its influence to cognitive function and it's neurological characteristics,accordingly,put forward the neuropsychological focus evaluation indexes and evaluation programs of cognitive impairment of leukoaraiosis,make for the differential diagnosis of cognitive impairment induced by other clear etiology,and provide the basis to early intervention.MethodsSubjects which meet inclusion criterias from neurology of Xinqiao Hospital of Third Military Medical University were included this A case-control study.Among them,30 subjects with OPVL who had only 3 to 13 mm of the posterior ventricle of the lateral ventricle were selected as the posterior horn group(PHG),and 32 subjects with white matter lessions in multi-site of the cerebral hemisphere as mixed group(MG)and 33 subjectswhich transcranial brain MRI confirmed whithout brain structural changes as control group(CN).three groups had matched general clinical datas such as demographic profiles,cerebrovascular disease risk factors.Neuropsychological evaluation was performed on three groups of subjects.The global cognitive function,was evaluated using the mini-mental state examination(MMSE)and the Montreal cognitive assessment scale(MoCA,Beijing).The digit span test(DST)and the clinical memory scale(CMS)were used to evaluates attention and memory respectively.Comparatively analysising the effect of OPVL on cognitive function and its neuropsychological characteristics.Results Compared with the CN,the average total scores of MMSE and MoCA were lower(P<0.01)in PHG,so did other subentries,such as the short-term memory,delayed memory,directed memory,orientation,and language test(P<0.01 or P<0.05).While some other subentries had no difference(P>0.05).The MG had lower scores than CN in the average total scores of MMSE and MoCA(P<0.01),and same as the abilities of memory,orientation,language,attention,visual spatial and executive,and abstraction(P<0.01 or P<0.05).Compared with the MG,the scores of abstraction,delayed memory,free recall of picture and portrait character association retrieval were significantly higher in PHG,while other subentries had no difference(P>0.05).ConclusionIsolated occipital periventricular leukoaraiosis lead to cognitive impairment,characterized by orientation,memory and language competence.