The Study On Cognitive Function Changes In Patients With Middle Cerebral Artery Stenosis With Endovascular Treatment

Objective To explore the changes of cognitive function before and after endovascular treatment of middle cerebral artery stenosis and its possible mechanism.Methods Twenty-two patients with middle cerebral artery stenosis were divided into treatment group and control group according to whether they received endovascular treatment or not.All subjects were evaluated 3 days before operation,3days after operation and 3 months after operation,and the changes of cognitive function between the two groups were compared.The cognitive function and emotion of patients were evaluated by Mini Mental State scale(MMSE),Montreal Cognitive Assessment scale(Mo CA),Cambridge Geriatric Cognitive examination scale(CAMCOG-C),language fluency test,Wechsler visual replication,digit span test and neuropsychological scales such as Hamilton anxiety scale(HAMA)and Hamilton Depression scale(HAMD).Vascular stenosis,cerebral perfusion and collateral circulation were evaluated by CT angiography(CTA),CT perfusion imaging(CTP)and digital subtraction angiography(DSA).Results In the treatment group,compared with those before and after operation,the delayed memory in Mo CA and the C1 of Wechsler visual replication were significantly improved during the 3-month follow-up period,and the score during the follow-up period was higher than that in the control group,while there was no significant difference in the abstract comparison of Mo CA subitems between the treatment group and the control group,but the abstract score in the treatment group was significantly higher than that in the control group during the follow-up period.In the digital span sequence,the postoperative and follow-up period of the treatment group were significantly improved as compared with those before operation,and the difference was statistically significant(p < 0.05).Multiphase(m CTA)and DSA showed that the collateral circulation in the treatment group was significantly improved after operation,and compared with that before operation,the cerebral perfusion in the treatment group was significantly increased,and the average transit time((MTT))was significantly decreased.Conclusion Endovascular treatment of middle cerebral artery stenosis may improve the cognitive function of patients by improving collateral circulation and increasing blood perfusion.