Effect Of Total Burden Of Cerebral Small Vessel Disease On Cognitive Function In Patients With Atherosclerotic Cerebral Infarction

Objective: To assess the total MRI burden of cerebral small vessel disease in patients with atherosclerotic cerebral infarction and cognitive function at 3 months after stroke.To explore the relationship between the total MRI burden of cerebral small vessel disease and post-stroke cognitive impairment.Methods: Patients with acute stroke hospitalized in Department of Neurology,Affiliated Hospital of Qingdao University from December 2015 to December 2017 were selected.According to TOAST etiological classification,205 patients with atherosclerotic cerebral infarction were selected.Detailed records of patients with hypertension,diabetes,coronary heart disease,hyperlipidemia and other vascular risk factors and the characteristics of general data such as age,gender,education years,etc.Magnetic Resonance Imaging was performed within 2 weeks of the onset of stroke.“The total SVD score”was used to evaluate the total MRI burden of cerebral small vessel disease.Montreal Cognitive Assessment Scale(Mo CA Scale)was used to assess the cognitive function of the patients.The National Institutes of Health Stroke Scale(NHISS score)was used to evaluate the poststroke neurological function of the patients,and the Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to exclude false cognitive impairment.After 3months of follow-up,the patients’ cognitive function was evaluated again.A total of192 patients were followed up and the data were complete.According to “the total SVD score”,there were 5 groups of 0 points,1 point,2 points,3 points,and 4 points.Analysis of risk factors for cerebral small vessel disease,risk factors for Post-stroke cognitive impairment.To investigate the influence of the total MRI burden of cerebral small vessel disease on cognitive function in patients with large atherosclerotic cerebral infarction and the correlation between the total MRI burden of cerebral small vessel disease and various cognitive impairment after stroke.Results:(1)Statistical analysis was performed on five groups of patients.The results showed that there was a statistically significant difference in hypertension(P=0.013).Age(r=0.426,P(27)0.05)was positively correlated with the “total SVDscore”.There was no significant difference in sex,diabetes,coronary heart disease,hyperlipidemia,prior stroke or history of TIA between the five groups(P(29)0.05),No linear correlation was found between the admission NIHSS,education years,and the“total SVD score”(P(29)0.05).(2)Univariate logistic regression analysis showed that age(OR value 1.246;95%CI 1.145-1.357,P(27)0.05)and the “total SVD score”(OR value 2.196;95% CI 1.533-3.145,P(27)0.05)were risk factors for poststroke cognitive impairment(PSCI).and years of education(OR value of 0.756;95% CI 0.664-0.861,P(27)0.05)were protective factors for PSCI.Multivariate logistic regression analysis showed that after adjusting for other common risk factors,age(P(27)0.05),education years(P(27)0.05),and the “total SVD score”(P(27)0.05)were still significantly associated with PSCI.(3)Spearman rank correlation analysis showed that there was a significant negative correlation between the “total SVD score” and the Mo CA score(r =-0.479,P(27)0.05).Linear regression analysis yielded the same results(R=-2.343,P(27)0.05).After adjusting for other risk factors,the results were still significant(R=-1.222,P(27)0.05).(4)The unadjusted linear regression results showed that the “total SVD score” was significantly negatively correlated with visual space and executive function,naming,memory,attention,language function,abstract thinking,and orientation(all P<0.01).After adjusting for other risk factors,the“total SVD score” is still significantly related to the reduction of visual space,executive function,and memory(P< 0.05).Conclusions:(1)Hypertension and age were important risk factors for the total MRI burden of cerebral small vessel disease in patients with atherosclerotic cerebral infarction.(2)The age and the total MRI burden of cerebral small vessel disease was a risk factor for PSCI in patients with atherosclerotic cerebral infarction.The education years were protection factors for PSCI in patients with atherosclerotic cerebral infarction.(3)The total MRI burden of cerebral small vessel disease has an important impact on post-stroke space,executive function and memory in patients with atherosclerotic cerebral infarction,and can be used as a predictor of PSCI.