Linear Measurement Of Brain Atrophy In SIVD Patients And Analysis Of Its Association With Cognitive Impairment

Objectives:To measure the lateral diameter of the cerebral ventricle and brain tissue in patients with subcortical ischemic vascular disease(SIVD)and to evaluate the cognitive function of patients with the Montreal Cognitive Assessment(MoCA)using a linear method.,Analysis of the relationship between the site of brain atrophy and cognitive impairment in patients with SIVD,and to explore the correlation between linear measurement index of brain atrophy and cognitive impairment in patients with SIVD,provide evidence for early diagnosis of cognitive impairment in patients with SIVD.Methods:1.According to the diagnostic criteria of SIVD,50 patients with SIVD who were treated or admitted to the Department of Neurology,Second Affiliated Hospital of Kunming Medical University from March 2017 to December 2017 were selected.At the same time,50 elderly patients were selected for physical examination in this hospital.People served as control groups.2.Collect clinical data of all subjects,including age,gender,years of education,past medical history(history of hypertension,history of diabetes,history of coronary heart disease,history of stroke and traumatic brain injury,and other history of liver and kidney dysfunction,etc.),History of smoking,drinking history.All enrolled subjects completed biochemical tests such as blood routine,liver and kidney function,thyroid function,and completed electrocardiogram and echocardiography examinations.3.MoCA was used to evaluate cognitive function of all subjects;all subjects were scanned using a 3.0T cranial MRI,and brain atrophy measurements were performed on MRI results using a linear method.To analyze the relationship between the site of brain atrophy and cognitive impairment in patients with SIVD,and to explore the correlation between linear measurement index of brain atrophy and cognitive impairment in patients with SIVD.Results:(1)There was no significant difference in gender,age,years of education,and vascular risk factors between the SIVD group and the control group;(2)MoCA scores and subgroups in the SIVD group and the control group.Visual space/executive function and delayed memory score the difference was statistically significant.The rest of the children were not statistically significant.(3)The maximal transversal a of the fourth ventricle in patient with SIVD,the widest distance b between the two forehead ventricles,and the caudal aspect of both lateral ventricles The mean distance between the nuclear head c,the width of the third ventricle d,the minimum distance e of the external lateral wall of the bilateral lateral ventricle,the width of the bridge pool f,and the g width of the anterior part of the cerebellum were all higher than those of the control group;There was no statistical difference in the width of the bridge pool f,but there were statistical differences between the other two groups.In the posterior cranial fossa of the SIVD group,the maximum transverse plane of the brain is the horizontal plane of the brain(h,b),the level of the brain(i,c)is the level of the brain,and the level of the brain of the brain is the distance between the midline of the posterior margin of the skull and the anterior edge of the fourth ventricle(n,g).The mean o value was smaller than that of the control group,but there was no statistically significant difference in the measured values of the brain tissue across the SIVD group and the control group.(4)In the SIVD group,the fourth ventricle index a/h,the forehead index b/i,the caudate nuclei index c/j,the Hough's value b+c,the Evans index c/b,the lateral ventricle body index e/k,The mean values of brainstem index f/n and cerebellar superior pool index g/o in eight brain atrophy measurements were significantly higher than those in the control group;except for the brain stem index,the other seven ventricle indexes were statistically different between the two groups.(5)Analysis of the correlation between the lateral diameter of the ventricles of the SIVD group and the total score of the cognition can still be considered as the maximum distance b between the two forehead ventricles and the minimum distance between the caudal nucleus on both sides of the bilateral lateral ventricle.There was a negative correlation between the third ventricle width d and the minimum distance e between the bilateral lateral ventricles and the total cognition.(6)In the SIVD group,there was a negative correlation between the MoCA score and the frontal horn index,caudate nucleus index,Hashimoto score,lateral ventricle body index,and third ventricle width;the visual space/execution function and the frontal horn index of the SIVD patients.There was a negative correlation between the caudate nucleus index,Hatch's number,and the width of the third ventricle;there was a negative correlation between the language of SIVD patients and the lateral ventricle body index,third ventricle width,fourth ventricle index,and brainstem index;patients with SIVD had a negative correlation.Delayed recall was negatively correlated with caudate nucleus index,Evans index,Hashimoto score,lateral ventricle body index,and third ventricle width;orientation and caudate nucleus index,Evans index,and lateral ventricle body index in patients with SIVD.There was a negative correlation between the width of the third ventricle;(7)The sulcus measurement in SIVD patients was significantly larger than that in the control group,and there was statistical difference between the two groups.The mean value of SIVD group was 5.1 mm,and that of the control group was 4.0 mm.The brain sulcus measurement value and MoCA total score of SIVD patients were analyzed.The correlation of its sub-items found that there was no correlation between the measurement of brain sulcus 1 in SIVD patients and the total scores of MoCA and children.Conclusions:(1)There was significant cortical and subcortical atrophy in SIVD patients compared with controls,and cognitive impairment in SIVD patients may be mainly associated with subcortical atrophy in SIVD patients.(2)MRI measurements of HIV in patients with SIVD,forehead angle index,caudate nucleus index,and third ventricle width can be used as predictors of frontal lobe atrophy;(3)Hashimoto's value,forehead angle index,caudate nucleus index,and third ventricle width can be used as predictors of overall cognitive,executive function/visual space and computational impairment in SIVD patients.