Clinical Study Of The Enlarged Perivascular Spaces In The Basal Ganglia Of Patients With Alzheimer's Disease And Mild Cognitive Impairment

Objective:With the development of magnetic resonance imaging(Magnetic resonance imaging,MRI),the detection rate of Enlarged perivascular spaces(EPVS)is getting higher and higher.Researches on EPVS are also concerned by scholars,especially EPVS and recognition.The relationship between cognitive function has become a research hotspot,but the relationship between EPVS and cognitive function is still inconclusive.In order to further study the correlation between cognitive function and EPVS of basal ganglia in patients with Alzheimer's Disease(AD)and Mild Cognitive Impairment(MCI),this study was conducted.Methods:(1)From March 2016 to April 2019,98 patients with Alzheimer's disease(AD)admitted to the Department of Neurology of the Third People's Hospital of Heze City,Shandong Province were selected as the AD group.94 patients with mild cognitive impairment(MCI)were regarded as the MCI group,and 87 elderly patients with normal cognitive function who were examined in the outpatient department of our hospital during the same period served as the control group.All the enrolled persons counted age,gender,education level,coronary heart disease,diabetes,hypertension history,smoking and drinking history,and all had uric acid,triglyceride(TG),low density lipoprotein(LDL-C),Examination of blood indexes related to homocysteine(HCY)and fasting blood glucose.(2)In AD group,MCI group and the control group,MMSE and MoCA were used for neuropsychological assessment and HAMA and HAMD were used for mental state assessment.(3)The three groups of subjects in the AD group,the MCI group and the control group were all subjected to 1.5T head MRI examination,and the basal ganglia EPVS was counted and graded by T2-weighted sequence imaging;the AD group and MCI group patients were further The correlation between EPVS rating and cognitive function score.Basal ganglia EPVS scoring criteria:score based on the number of unilateral basal ganglia EPVS:0=no EPVS,1=less than 10 EPVS,2=11-20 EPVS,3=21-40 EPVS,4=more than 40 EPVS.EPVS classification is based on the diameter:No EPVS is 0,EPVS diameter<2mm is 1 grade,EPVS diameter 2?3mm is 2 grade,diameter>3mm is 3 grade.(4)The statistical data were analyzed using IBM SPSS 21.0,the?~2/Z test was performed on the EPVS grade composition of the AD group,MCI group,and normal control group.The t/F test was performed on the EPVS score between the three groups,and the Spearman test AD Correlation between EPVS classification and cognitive function in group and MCI group.Univariate and multivariate linear regression were used to test the correlation between cognitive function and EPVS score and classification.The significance level of P<0.05 was considered statistically significant,P<0.001 was considered statistically significant.Results:(1)General situation:AD group,MCI group and control group have no difference in age,gender,education level,LDL-C,TG,HCY,uric acid,blood sugar,history of hypertension,history of diabetes,history of coronary heart disease and history of smoking and drinking Academic significance(P value>0.05).The MMSE score and MoCA score of AD group,MCI group and normal control group were significantly different(P<0.05).(2)Comparison in the scores of EPVS in basal ganglia among the three group:Compared with control group,the scores of EPVS in AD group and MCI group were significantly higher,the difference was statistically significant(P<0.05).EPVS scores of MCI group were significantly lower than AD group,the difference was statistically significant(P<0.05).According to the age:60?80 years old,compared with control group,the scores of EPVS in AD group and MCI group were significantly higher(P<0.05);EPVS scores of MCI group were significantly lower than AD group(P<0.05).Patients of AD group,MCI group and normal control group over 80 years old,There was no significant difference in EPVS score among the three groups(P>0.05).(3)Comparison in grade of EPVS in basal ganglia among the three group:EPVS:The AD and MCI group had the highest proportion of grade 1,while the control group had the highest proportion of grade 0.Compared with the control group,the composition of EPVS in AD group and MCI group were statistically significant(Z=-4.484,Z=-2.832;P<0.05).There was no statistically significant difference in the composition of EPVS in AD group and MCI group(P>0.05).According to the age:60?80 years old,compared with control group,the difference of EPVS classification composition in ADandMCI group was statistically significant(Z=-3.731,Z=-1.465;P<0.05).>80 years old,there was no significant difference in the composition of EPVS among the three groups(P>0.05).(4)Correlation analysis between EPVS grade,MMSE score and MoCA score in AD group and MCI group:EPVS grade was negatively correlated with MMSE score(?=-0.648,?=-0.725,P<0.05).EPVS grade was negatively correlated with MoCA score(?=-0.713,?=-0.905,P<0.05).(5)A single factor analysis of cognitive function in AD group and MCI group showed that:EPVS score,EPVS grade,age,history of hypertension,uric acid,coronary heart disease were influencing factors of cognitive function(P<0.05).However,gender,education level,smoking and drinking history have no significant effect on cognitive function(P>0.05),and laboratory blood test indexes TG,LDL-C,HCY and blood glucose levels have no significant effect on cognitive function(P>0.05)),further multivariate regression analysis showed that:EPVS score,grade and hypertension are related to cognitive function(P<0.05).Conclusion:(1)Patients in AD group and MCI group have higher basal ganglia EPVS score and classification.After age stratification:the 60-80-year-old age group,the elderly with normal EPVS scores and grades in AD and MCI patients are higher than 80 years old,the difference is not obvious.(2)The cognitive function of patients with AD and MCI is related to the basal ganglia EPVS grade and score,and hypertension.EPVS and hypertension in the basal ganglia are independent risk factors for cognitive impairment in patients with AD and MCI.(3)The correlation between EPVS and cognitive dysfunction in patients with AD and MCI still needs a large sample and multi-center further investigation.