Analysis Of Risk Factors Related To Cognitive Impairment After Acute Thalamic Infarction

Objective: The aim of this study was to investigate the cognitive impairment of 40 patients with acute thalamic infarction and to analyze the potential risk factors,so as to provide corresponding guidance and suggestions for clinical treatment.Methods: The clinical data of 40 patients with acute thalamic infarction admitted to First Affiliated Hospital of China Medical University from July 2021 to December 2022 were collected,and the cognitive function was assessed by the Mo CA scale.Patients with corrected Mo CA <26 points were included in the cognitive impairment group(24 cases),while those with Mo CA ≥26 points were included in the non-cognitive impairment group(16 cases).The collected data of the two groups were compared,including gender,age,body-type index(BMI),educational background and past history(such as hypertension,diabetes,hyperlipemia,hyperuricemia,hyperhomocysteinemia,coronary heart disease,atrial fibrillation,smoking history,and drinking history).The American National Institutes of Health Stroke Scale(NIHSS)score and biochemical parameters at admission(including fasting blood glucose,TG,TC,LDL,HDL,CRP,creatinine and uric acid)were also analyzed for differences.In addition,the thalamic infarction site(divided into anterior,lateral,paravertebral,and posterior according to the characteristics of thalamic infarction blood supply)and left-sided,right-sided,and bilateral thalamic infarctions were analyzed by univariate analysis.The factors with significant differences were combined and entered into a multivariate binary Logistic regression analysis to analyze the effect of related factors on the occurrence of cognitive impairment after acute thalamic infarction,and the output was visualized by a forest map.At the same time,the receiver operating characteristic(ROC)curve,Nomogram and Calibration calibration curve were used to evaluate the predictive effect of related factors on the occurrence of cognitive impairment after thalamic infarction.Results: Through the inter-group statistical analysis,we found that there were no significant differences between the cognitive impairment group and the non-cognitive impairment group in terms of gender,BMI,educational level,smoking,drinking,hypertension,diabetes,coronary heart disease,infarction volume,left-right-sided and bilateral thalamic infarctions,fasting blood glucose,glycosylated hemoglobin,TG,TC,LDL,HDL,CRP,creatinine and uric acid(P>0.05).In the univariate analysis,four factors(age,thalamic infarction site,admission NIHSS score,and hyperhomocysteinemia)suggested significant differences between the two groups(P<0.05).The age(cognitive impairment group 63.04±10.56 years,non-cognitive impairment group 55.06±13.93 years),thalamic infarction site(cognitive impairment group anterior 9 cases,paravertebral 4 cases,posterior 1 case,lateral 10 cases,non-cognitive impairment group anterior 1 case,paravertebral 1 case,posterior 1 case,lateral 13 cases),admission NIHSS score(cognitive impairment group 1(0,2),non-cognitive impairment group 1(0,1),and hyperhomocysteinemia(cognitive impairment group 17 cases(66.6%),non-cognitive impairment group 3 cases(18.75%)with significant differences in the difference analysis were included in the multivariate binary Logistic regression analysis,and finally,hyperhomocysteinemia and anterior thalamic infarction were found to be probably independent risk factors for cognitive impairment after thalamic infarction(P<0.05).Conclusion: HHcy and anterior thalamic infarction are probably independent risk factors for cognitive impairment after acute thalamic infarction.