The Changes Of Hippocampal Structure In Cerebral Small Vascular Cognitive Impairment

Objective This study was designed to analyze the neuropsychological assessment,the characteristics of hippocampal structure of Va MCI,VD and AD patients and their correlation,and to provide objective basis for early detection of cognitive function changes of cerebral small vascular cognitive impairment.Methods 30 patients of Va MCI,28 patients of VD,30 patients of AD from November 2017 to August 2018 were selected in the first hospital of Jilin University.Another 30 healthy people matched by age,sex,and education level were selected.Record the clinical datas,neuropsychological examinations,including MMSE,Mo CA,MES,ADL,HIS and CDR.MRI imaging was performed in all of them.The border of bilateral hippocampus was delineated manually in 3D-MPRAGE sequence by using ITK-SNAP software,and the volume of hippocampus was automatically generated.To analyze the characteristics of hippocampal volume in patients with Va MCI,Va D and AD and its relationship with neuropsychological scores.Results 1.There was no significant difference in general data(including age,sex,educational years,past medical history,smoking and drinking history)between the four groups of subjects in this study(P>0.05).The volume of bilateral hippocampus was negatively correlated with age(r=﹣0.255,P<0.05),but not with sex and years of education(P>0.05).2.(1)Control group,Va MCI group and VD group: In MMSE,Mo CA,MES,MES-M,MES-E,ADL score,the difference was statistically significant(P<0.05),there was no significant difference in the score of MES-R(P > 0.05).There were significant differences between the two groups in the MMSE,Mo CA,MES,MES-M,and MES-E scales.The difference between the control group and the VD group,Va MCI group and VD group was statistically significant(P<0.05).There was no significant difference between the control group and the Va MCI group(P>0.05).The ADL scores were compared between the two groups.There were significant differences between the control group and the Va MCI group,the control group and the VD group(P<0.05).There was no significant difference between the Va MCI group and the VD group(P>0.05).The volume of bilateral,right and left hippocampus were: control group > Va MCI > VD.There was significant difference among the three groups(P < 0.05).After further comparison between each group,the differences in left hippocampal volume between the two groups were statistically significant(P<0.05).The healthy group and VD,Va MCI and VD of bilateral and right hippocampal volume were statistically different(P<0.05),while there was no significant difference between the healthy group and Va MCI(P > 0.05).In the three groups,hippocampal volume(bilateral,right and left)was positively correlated with MMSE,Mo CA and MES,and negatively correlated with ADL.The correlation coefficient of Mo CA was highest.(2)There was no remarkable difference between AD and VD in the scores of MMSE,Mo CA,MES,MES-M,MES-E,ADL scale,bilateral,right and left hippocampal volume(P>0.05).Conclusion 1.CSVCI patients may have atrophy of hippocampal volume,and the lower the cognitive function and daily living ability,the more obvious atrophy of hippocampal volume.2.The atrophy of the left hippocampal volume can be used as an objective indicator for CSVCI to assist diagnosis.3.Small vasogenic VD has the same degree of hippocampal atrophy,decreased cognitive level,and decreased daily living ability in patients with AD.4.The volume of hippocampus is drastically correlated with age.With the increase of age,the volume of hippocampal structure decreases gradually.It has nothing to do with gender or education.