ABSTRACT
Objective To explore the clinical characteristics of the cognitive disorder in patients with small vessel disease(SVD).Methods A total of 60 patients with SVD and 50 age,gender-matched healthy subjects were recruited consecutively from the Department of Neurology,Beijing Chaoyang Hospital. All the participants were performed by a battery of neuropsychological tests.The Fazekas scale was used to as-sess the severity of white matter lesions,and the scale of medial temporal lobe atrophy(MTA)was used to e-valuate the severity of medial temporal lobe.Results Patients with SVD were associated with global cogni-tive function deficits,including the general tests of MMSE((25.9±2.4)vs(28.1±1.7))and MoCA((23.0 ±3.7)vs(26.2±3.0)),and also with performances of AVLD-I((5.0±1.0)vs(8.2±2.0)),AVLT-D((3.7± 1.0)vs(9.3±1.9)),AVLT-R((7.6±1.5)vs(11.7±1.6)),TMT-B,Stroop B,Stroop C and DST(P<0.05). The score of MOCA was related negatively with Fazekas scale(r=-0.361,P=0.04).The severity of Fazekas had a positive relationship with the scores of MTA(r=0.449,P=0.032).Conclusion Patients with SVD are closely correlated to general cognitive impairment,especially with memory decline,attention and executive function,which may be attributed to the impairment of frontal-subcortical circle.
ABSTRACT
Objective Vascular mild cognitive impairment(VaMCI) refers to mild cognitive impairment caused by or associated with vascular causes.This study aims to investigate the characteristics of the cognitive impairment in patients with vascular mild cognitive impairment (VaMCI).Methods Seventy-five patients with VaMCI(VaMCI group) and 38 healthy old subjects whose age, sex and education level match the VaMCI group patients(control group) were recruited from the department of Neurology, Beijing Chaoyang Hospital, Capital Medical University between Jan 2016 and June 2016.The neuropsychological examinations were used to evaluate the severity of cognitive impairment, specifically including the Minimum Mental State Examination(MMSE), Montreal cognitive assessment scale(MoCA), Clinical Dementia Rating(CDR), Activity of Daily Living Scale(ADL), Hachinski ischemic score table, Hamilton Depression Scale(HAMD) and Auditory Verbal Learning Test(AVLT).The Fazekas scale was used to assess the severity of white matter lesions, and the medial temporal lobe atrophy rating scale(MTA) was used to evaluate the atrophic severity of medial temporal lobe.Results The overall cognitive function score in VaMCI group was significantly lower than the control group [MMSE [25.7±2.3 vs 28.4±2.0] MoCA [22.8±3.9 vs 26.3±3.7]], the differences was statistically significant(P<0.05);as well as the AVLT-I [5.1±1.0 vs 8.9±1.9], AVLT-D [3.7±1.0 vs 9.8±1.5] and AVLT-R [7.6±1.9 vs 12±1.5] scores in VaMCI group was significantly lower than the control group, the differences was statistically significant(P<0.05), which suggested patients with VaMCI have overall cognitive impairment, especially memory impairment.But Fazekas and MTA scores in VaMCI groups were higher than the control group, the differences was statistically significant(P<0.05).Correlation analysis showed that the scale of medial temporal lobe atrophy had a negative relationship with the performance of MoCA (r=-0.434,P=0.002).Conclusion Our findings demonstrate patients with VaMCI have significant cognitive impairment, especially memory impairment, which may be correlated to the severity of the white matter lesions and the medial temporal lobe atrophy.
ABSTRACT
Objective To explore ihe physiological changes of the late-onset depressive(LOD) persons during sleep.Methods 15 cases of LOD patients formed a group and 10 healthy aging persons formed a control group.Hamilton Depression Scale (HAMD) was used to score the severity of depression and polysomnographic recorders were used to monitor the whole night long.The subjective feelings of the sleep and the daytime mental status were assessed in the morning.Results Compared with the controlde group, the LOD patients obviously possessed a disordered sleeping process: sleep efficiency was lower( ( 59.20 ± 2.90 ) %, ( 77.09 ± 1.55 ) %, P ＜0.01 ); their sleep latency was longer( (54.00 ± 4.97 ), ( 24.00 ± 2.91 ), P ＜ 0.01 ); the numbers of rapid eye movement(REM) sleep phase and rapid eye movement latency(REML) were strikingly different(P＜0.01 ).Compad with the control group, the LOD patients' awakening time and percent were significantly increased.Not only were the time and percentage of S2 sleep phase much higher, but the time of slow wave sleep was shorter.Besides,REM sleep activity, its density, and its intensity were raised (P ＜ 0.05 ).Conclusion There is a disturbance of the objective physiological indexes happening among the LOD patients.The increase of S2 sleeping time and percentage and the disinhibition of REM sleep can be used as the diagnosis indexes of LOD patients' specificity.