The Relationship Between White Matter Hyperintensity In Different Parts Of The Brain And Cognition And Hemodynamics In Patients With Mild Stroke

Objective:Research on the cognitive influencing factors of patients with mild stroke usually focuses on the location and size of the infarction,but more and more evidence shows the importance of white matter hyperintensity(WMH)in the cognitive function of patients with mild stroke.This study intends to investigate the influence of WMH volume in different parts of patients with mild stroke on visual-spatial working memory and attention,as well as related factors that affect WMH volume.Methods:Include 40 patients with WMH in mild stroke as the research objects.Use Cambridge Cognitive Test System(CANTAB,version 5.0.0)for cognitive function evaluation,sample delayed matching(Delayed Matching to Sample,DMS)average correct delay to evaluate visual spatial working memory,simple reaction time(SRT)average delay evaluates attention.UBO Detector white matter segmentation software detects the size of WMH in different parts,and Transcranial Doppler(TCD)measures cerebral vascular hemodynamic parameters.Elaborating:1.The basic characteristics of imaging,cognitive domain,and hemodynamics of the research object;2.The influence of WMH volume of different parts on visual spatial working memory;3.The influence of WMH volume of different parts on attention;4..Factors affecting the size of WMH.Results:1.Correlation analysis between WMH volume in different parts and visual spatial working memory shows:total WMH volume(R~2=0.303,P-Value R~2=0.042),DWMH volume(R~2=0.348,P-Value R~2=0.021),frontal lobe WMH volume(R~2=0.474,P-Value R~2=0.001)is related to the average correct delay of DMS in patients with mild stroke;2.Correlation analysis between WMH volume and attention in different parts shows:total WMH volume(R~2=0.397,P-Value R~2=0.007),PVWMH volume(R~2=0.388,P-Value R~2=0.009),DWMH volume(R~2=0.363,P-Value R~2=0.015),frontal lobe WMH volume(R~2=0.340,P-Value R~2=0.024),parietal WMH volume(R~2=0.319,P-Value R~2=0.037)was significantly correlated with the average delay of SRT in patients with mild stroke.3.Correlation analysis between infarct location and visual spatial working memory and attention:average correct delay between infarct location and DMS(R~2=0.165,P-Value R~2=0.518),average SRT delay(R~2=0.192,P-Value R~2=0.393)irrelevant.4.The multi-factor linear regression of PVWMH volume,DWMH volume,and WMH volume of each lobe on visual-spatial working memory and attention of patients with mild stroke showed that after controlling for age,gender,education level and other variables,1.DWMH volume is still significant Affect the average correct delay of DMS(β=0.685,95%CI=0.077-0.553,P=0.011)and the average delay of SRT(β=0.582,95%CI=0.060-0.492,P=0.019).2.The volume of frontal lobe WMH still significantly affects the average correct delay of DMS(β=0.758,95%CI=0.331-1.465,P=0.003)and the average delay of SRT(β=0.417,95%CI=0.308-1.072,P=0.032).5.The multi-factor linear regression of the factors affecting the size of WMH shows that the pulsatility of the middle cerebral artery has an effect on the total WMH volume(β=0.700,95%CI=48681-109186,P<0.001),PVWM volume(β=0.762,95%CI=35633-70502,P<0.001),DWMH volume(β=0.638,95%CI=2.895-7.634,P<0.001)have significant effects.Conclusions:1.The attention and visual-spatial working memory of patients with mild stroke and WMH are affected by the WMH volume of different parts;2.the infarct position has little effect on the attention and visual-spatial working memory of patients with mild stroke;3.the WMH volume of patients with mild stroke is affected by the pulsation of the middle cerebral artery influences.