The Research Of Correlation Between Cognitive Impairment And Serum A? Levels In Chronic Insomnia With Depression And OSAHS

Objective:1.Through the collection of basic information,evaluation of neuropsychology scales,and detection of serum A? levels on patients with chronic insomnia and non-insomnia,investigate the relationship between depression,cognitive impairment and serum A? levels.Find early biological markers of cognitive dysfunction in patients with chronic insomnia and depression.2.Cardiopulmonary Coupling(CPC)was used to screen patients with OSAHS,through cognitive-related scale assessment and detection of serum A? level to investigate the relationship between cognitive impairment and serum A? levels,provide possible serological evidence for studies of cognitive impairment in patients with chronic insomnia and OSAHS.Method: 1.Collected patients with insomnia at the Department of Neurology Outpatient and Sleep Disorders Specialist Clinic of Tianjin General Hospital from June 2017 to December 2017,and selected 58 patients corresponding to ICSD-3 chronic insomnia disorder criteria as the chronic insomnia group.26 Patients without insomnia who were made physical examination at Health Examination Center served as a control group.All subjects were collected for basic information,evaluated neuropsychology scales,including:1.sleep related scales,such as PSQI,ISI;2.emotional related scale: Hamilton Depression Scale(HAMD);3.cognitive function related scale: Montreal Cognitive Assessment(MoCA).All subjects were measured serum levels of A?.According to whether or not there is insomnia,the severity of insomnia,whether there is cognitive impairment and depression,the subjects will be divided into different groups.Investigate depression and cognitive impairment in patients with chronic insomnia and the relationship between depression,cognitive impairment and serum A? levels.2.Collected 47 patients with chronic insomnia,according to the results of CPC,they were divided into 18 cases with chronic insomnia with OSAHS and 29 cases with chronic insomnia without OSAHS.26 Patients without insomnia served as a control group.All subjects were collected for basic information,evaluated MoCA scale and measured serum A? levels.Analyze and compare the differences between the MoCA scale scores and serum A? levels in each group,and explore the correlation between them.Result: 1.Compared with non-insomnia group,chronic insomnia group had significantly higher HAMD scores and serum A?,and lower scores of MoCA,visual space,executive function and delayed recall(p<0.05).2.Compared with non-insomnia group,the scores of MoCA and delayed recall were significantly decreased,and serum A? levels were significantly increased in mild chronic insomnia group(p<0.05).Comparing with non-insomnia group,the total scores of MoCA,visual space and executive function,delayed recall and attention were significantly decreased,and serum A? levels were significantly increased in moderate and severe chronic insomnia group(p<0.05).The scores of attention were significantly decreased in the moderate-severe chronic insomnia group compared with the mild chronic insomnia group(p<0.05).And serum A? levels had an upward trend,but the difference was not statistically significant(p>0.05).3.There was a negative correlation between MoCA total score,delayed recall score and serum A? levels in mild chronic insomnia group(p<0.05).In moderate-severe chronic insomnia group,there was a negative correlation between MoCA total score,delayed recall score and serum A? level,but there was no significant correlation between visual space and executive function,attention score and serum A? level(p>0.05).4.Compared with chronic insomnia with normal cognitive function group and non-insomnia group,serum A? levels were significantly higher in chronic insomnia with cognitive decline group(p<0.05).The levels of serum A? in patients with chronic insomnia and normal cognitive function were higher than those in the non-insomnia group,but the difference was not statistically significant(p>0.05).5.There was a negative correlation between total score of MoCA and serum A? levels in patients with chronic insomnia and cognitive decline group(p<0.05).6.Compared with non-insomnia group,the scores of MoCA and delayed recalls was significantly decreased in chronic insomnia group(P<0.05).Compared with non-insomnia group,the scores of MoCA,visual space and executive function,delayed recall scores were significantly decreased,and serum A? levels were significantly increased in chronic insomnia with depression group(P<0.05).The total score of MoCA in the chronic insomnia with depression group was lower than that in the insomnia group,and the serum A? level was increased,but the difference was not statistically significant(P>0.05).7.There was a negative correlation between scores of MoCA,visual space and executive function,delayed recall scores and serum A? levels(P<0.05).8.In the group of chronic insomnia with OSAHS,chronic insomnia without OSAHS and control,the scores of MoCA total score,visual space and executive function,and delayed recall increased in turn,and the serum A? levels decreased in turn.The difference was statistically significant(p <0.05).9.There was a negative correlation between MoCA total score and delayed recall scores and serum A? levels in chronic insomnia with OSAHS group(P<0.05).There was no significant correlation between visual space and executive function scores and serum A? levels(P>0.05).Conclusion:1.Patients with chronic insomnia have depression,cognitive impairment,and cognitive impairment are more significant in the visual space,executive function and delayed recall areas.2.In patients with chronic insomnia,the more severe the insomnia,the more obvious the impairment of cognitive function,and the more extensive impairment of the cognitive domain,and serum A? levels have a rising trend.3.Serum A? levels increase in patients with chronic insomnia with decreased cognitive function;4.Patients with simple chronic insomnia suffered from cognitive impairment,manifested as delayed recall,but did not cause changes in serum A? levels.5.Chronic insomnia with depressive patients had cognitive impairment,especially in visual space and executive function,and delayed recall.The level of serum A? increased,and cognitive impairment had a significant correlation with serum A? levels.Serum A? can be used as an early biomarker of cognitive dysfunction in patients with chronic insomnia with depression.6.OSAHS can aggravate the degree of cognitive impairment in patients with chronic insomnia,especially in visual space and executive function,delayed memory significantly.And the level of serum A? in patients with chronic insomnia with OSAHS was increased,there was a significant correlation between cognitive impairment and serum A? levels.Serum A? can be used as a biological marker of cognitive impairment in patients with chronic insomnia with OSAHS,providing possible serological evidence for the study of cognitive dysfunction in patients with chronic insomnia and OSAHS.