ABSTRACT
Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.
ABSTRACT
Objective To investigate the relationship between cognitive impairment and the other clinical features of subcortical damage in patients with magnetic resonance imaging(MRI)-defined subcortical ischemic vascular disease(SIVD).Methods The cohort for this study included 110 SIVD patients who were divided into 3 groups according to cognitive status:patients with noncognition impairment(SIVD-NCI group,n=34),patients with mild cognitive impairment(SIVD-MCI group,n =47) and patients with vascular dementia (SIVD-VaD group,n =29).The cognitive functions were evaluated by the mini-mental state examination (MMSE) and Montreal cognitive assessment(MoCA),the Cambridge cognitive examination-Chinese version(CAMCOG-C),activity of daily living scale(ADL) and clock drawing task(CDT),etc.Depression symptoms were assessed by the geriatric depression scale (GDS),while the other clinical features of subcortical damage were assessed by the timedGet-Up and Go test,etc.Results There were statistically significant differences in the MMSE,MoCA,CAMCOG-C,CDT and ADL scores among the three groups(H=85.36,F=50.32,55.03,H=27.39,40.87,respectively,all P＜0.05).Gait disturbance,urinary disorder,pseudobulbar palsy,depression and falls were statistically significantly different among the threegroups(x2=21.69,21.41,25.51,6.91,21.87,all P＜0.05).In addition,gait disturbance was increasingly aggravated with the severity of cognitive impairment.In SIVD-MCI group,urinary disorder,pseudobulbar palsy and falls were significantly increased as compared with SIVD-NCI group (x2 =15.57,16.31,8.92,both P＜0.017).Depression was statistically significant different between SIVD-NCIandSIVD-VaD group(x2 =6.90,P＜0.017).Among the three groups,there was no significant difference in the feature of emotional incontinence.Conclusions With the decline in cognitive function,the patients with SIVD can present with different clinical features of subcortical damage.Gait disturbance is gradually aggravated with the decline in cognitive function.Urinary disorder,pseudobulbar palsy,and falls can reflect the cognitive impairment from normal to mild on the other hand.Depression can be used as one of the signs that show cognitive impairment reached to dementia.
ABSTRACT
Objective To explore the relationship of cognitive impairment and depression in subcortical ischemic vascular disease (SIVD).Methods Neuropsychological scales were used to investigate the level of cognitive impairment and depression syndrome.According to the diagnostic criteria,the participants were divided into three groups:non-cognitive impairment group (SIVD-NCI),mild cognitive impairment group (SIVD-MCI),and dement group (SIVD-D).Depending on the clinical syndrome and the Geriatric Depression Scale (GDS),the participants were divided into depression group and non-depression group.The interaction of cognitive impairment and depression was analyzed using Analysis of Covariance (ANCOVA).Results The main effect of cognitive impairment was significant in all the Cambridge Cognitive Examination-Chinese version (CAMCOG-C) subscales,while the major function of depression in most of the CAMCOG-C subscales.The interaction of cognitive impairment and depression was significant only in executive function (F =6.835,P =0.001),attention (F =3.126,P =0.047),language (F =3.352,P =0.038) and comprehension of language (F =5.324,P =0.006).The interaction of cognitive impairment and depression was significant in executive function(F =14.255,P =0.000) and comprehension of language (F =3.971,P =0.049) between SIVD-NCI group and SIVD-MCI group while in attention (F =4.918,P =0.030) between SIVD-MCI group and SIVD-D group.Conclusions Patients of SIVD have varying degrees of cognitive impairment and depressive symptoms.Those with depression symptoms have more cognitive impairment than non-depressed patients.Cognitive impairment and depression show interaction in different subscales of cognitive function in different time.