The Relationship Between Ischemic White Matter Lessions And Cognitive Impairment And Its Syndrome Elements

Objectives:To study the syndrome elements of white matter lessions,the relative risk factors of cogni tive impairment which was due to ischemic white matter lessions,and the effects of different parts and degrees of WML on cognitive function.Methods:100 patients with WML were selected form the department of brain diseases of Nanjing Hospital of T.C.M,including 50 patients with Cl and 50 patients with normal cogni tion function.Meanwhi le,20 healthy people were selec ted as the normal control group.Collecting The general data of 120 patients,the cognitive funct i on which was evaluated by MMSE,MoCA scale and the syndrome elements of CI.First of all,according to the scores of CI group and normal group,the main syndrome elements of WML cognitive impairment are discussed.Secondly,demographic data and vascular r isk factors of every patient were collected and compared between the nor mal cognition group and abnomal cognition group to find the risk factors of CI about WML.Finally,the patients with WML were classified into PVL group and DWML group according to the imaging features.Compared with the normal control group,the effects of WML on cognitive function and cognitive domain were discussed.The degree was divided into three groups:mild groupmoderate group and severe group.Compared with the normal control group,the influence of the degree of WML on cogni tive func ti on was studied.Resul ts:The scores of dystrophy,blood stasis and phlegm turbidity in the Cl group were higher than those in the normal cognitive group,and the difference was statistically significant(P<0.05).Univariate analys is showed that WML patients of Cl was associated wi th age,smoking hi st ory,hypertension and hyperlipidemia(P<0.05),and logistic regression analysis showed that was most related to age(OR=1.094,P<0.001).The scores of PVL and DWML in the CI group were lower than those in the normal control group(P<0.05)which was in MoCA score and all cognitive domains.In visual space and executive power,language and delay recall functionin,There was no di fference between PVL group and DWML group(P<0.05).In naming,calculation and orientation function,PVL group scores were lower than DWML group(P<0.05),and DWML group scores were lower than PVL group in abstract function(P<0.05).Cognitive impai rment was divi ded into three groups according to the degree of lession.In terms of MoCA score,visual space and executive power,calculation and naming function,the scores of each case subgroup were lower than that of the control group,and there was a significant difference among the three subgroups(P<0.05).Attention and language function scores in moderate and severe group were lower than those in mild group and control group(P<0.05).The ability of orientation in each group was lower than that in control group(P<0.05)and the scores in moderate and severe group was lower than other groups(P<0.05).In abstract function,the score in severe group was lower than that in ot.her groups(P<0.05).The delayed recall function in each case subgroup was lower than that in the control group,but there was no differ ence between the three groups(P>0.05).Conclusion:1.The main sydrome elements of patients with CI in WML are phlegm turbidity,blood stasis and dystrophy.2.Cognitive dysfunction in patients with WML may be related to age,smoking history,hypertension and hyperlipidemia,which may be most related to age.3.Pati.ents with WML may have visual space,executive power,delayed recal l,attention and calculation power,orientation and other cognitive areas damage.The more severe the white matter lesion,the deeper the cognitive dysfunction,and the wider the damaged cognitive domain.4.All the WML in different parts of the brain can lead to CI,but different parts may infect different cognitive domains.