ABSTRACT
ObjectiveTo explore feasibility study of the Montreal cognitive assessment (MoCA) in detecting subcortcial vascular cognitive impairment-no dementia(VaCIND-S).MethodsSeventy-five Chinese Han were assessed by the MoCA and MMSE.40 met criteria for VaCIND -S and 35 were considered cognitively normal.ROC curve analyses were performed to determine optimal sensitivity and specificity.ResultsNo differences were found between groups on age,gender,education degrees.According to their MoCA scores,cognitive impairments including memory,visuospatial,executive function,attention,language,and orientation sub-scores in VaCIND-S ( (0.43 ± 1.01),(2.21 ± 1.19),(2.11 ± 1.13),(4.66 ± 1.48),(4.42 ±1.31),(4.86 ± 1.12)) significantly decreased compared with those in controls( (2.93 ± 1.36),(3.29 ± 1.06),(3.53 ±0.93),(5.94 ±0.24),(5.44 ± 0.71 ),(5.80 ± 0.48 ) ) (P ＜ 0.05 ).The MMSE scale was insensitive to cognitive impairment as compared with MoCA scale.Using cut-off score of 23.5,the MoCA exhibited excellent sensitivity (0.971 ) and specificity (0.789).ConclusionMoCA is a more sensitive instrument than the MMSE for the detection of VaCIND-S and warrants further investigation regarding its applicability in large and varying ethnic population.
ABSTRACT
Objective To investigate the clincal characteristics of central hyponatremia.Methods The clinical data of 34 patients with central hyponatremia were analysed retrospectively.Results 34 patients with different cerebral diseases appeared dysphoria,sleepiness,aggravating disturbances of consciousness,vomiting,limb seizures and dehydration basis on primary diseases during the hospitalization.The laboratory examinations showed that the level of blood natrium was 260 mmol/d in all the cases,and the central venous pressures in 5 cases were lower than 6 cm H2O among 8 cases.The 19 cases were diagnosed as central hyponatremia——syndrome of inappropriate ADH secretion(SIADH);7 cases were diagnosed as central hyponatremia——cerebral salt wasting syndrome(CSWS).The other 8 cases were diagnosed as SIADH firstly,but final diagnosis were corrected as CSWS according to the symptoms increasing after dehydration therapy.The 19 case of SIADH received the therapy of limiting water and diuresis,and 15 cases of CSWS received the therapy of hydration and supplementing sodium.The several days after the treatment,the levels of the blood natrium and the urinary natrium were backed to the normal values in all the patients and the condition was improved exapet 3 cases remained coma.Conclusions Hyponatremia,hypernatruria and changes of consciousness are the clinical charateritics of central hyponatremia.The treatment principle in SIADH is limiting water,and in CSWS is hydration and supplementing sodium.