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Objective To explore the correlated factors and clinical features of cognitive impariment in parkinson's disease (PD).Methods A total of 419 patients with PD were collected from Xiangya Hospital of Centre-South University during Mar 1st,2017 to Nov 30th,2017.The cognitive functions of patients were assessed with the Mini-Mental State Examination (MMSE),and the basic information and the motor symptoms of 419 PD patients were selected at the same time.The PD patients were classified into three groups according to the MMSE score:PD with no cognitive impairment (PD-NC),mild cognitive impairment in PD (PD-MCI),and Dementia in PD (PD-D).The data were analyzed by SPSS 20.0.Results There were 156 patients with PD-MCI (37.2％) and 64 patients with PD-D (15.3％).The difference of sex and disease duration among three groups were not statistically significant (P ＞ 0.05).The significant difference was found among PD-D,PD-MCI,and PD-NC groups in age of onset,age,educational attainment,Unified Parkinson's disease Rating Scale (UPDRS)-Ⅱ score,UPDRS-Ⅲ score and Hoehn-Yahr stage (P ＜ 0.05).There were significant differences among three groups in MMSE score and its items (P ＜ 0.01).Logistics regression analysis found that the age of onset,educational attainment,and Hoehn-Yahr stage were the risk factors of cognitive impairment in PD patients (P ＜ 0.05).Conclusions Cognitive impairment is common in PD patients,and it is relevant to the age of onset,educational attainment and the severity of illness of PD patients.
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Objective To explore the relationship between blood levels of visfatin and glycolipid metabolism and mild cognitive impairment (MCI) in patients with type 2 diabetes (T2DM).Methods From February 2016 to January 2017,a total of 91 patients with T2DM were recruited as investigation objects.Cognitive function was measured by Montreal Cognitive Assessment (MoCA),and fasting serum was collected to determine the relevant laboratory indexes.Results In the 91 patients,50 cases developed MCI.Compared to non-MCI group,MCI group had significant difference in age,total cholesterol,insulin,insulin resistance index,visfatin,MoCA score and diabetic retinopathy (P ＜ 0.05).Pearson correlation analysis showed that the MoCA score was negatively correlated with visfatin and insulin resistance index (P ＜0.05).Further logistic regression analysis showed that age,diabetic retinopathy,insulin resistance index and visfatin were independent risk factors for MCI in T2DM patients.Conclusions MCI in T2DM patients increases with the increasing of elder,diabetic retinopathy,insulin resistance index,and visfatin.
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Objective To investigate the white matter injury in patients with systemic lupus erythematosus (SLE) combined with cognitive dysfunction by diffusion tensor imaging (DTI).Methods The Montreal cognitive assessment,conventional magnetic resonance imaging (MRI) and DTI were performed in 11 SLE patients with cognitive dysfunction (CDF),11 SLE patients without cognitive dysfunction (nonCDF) and 10 health controls.Local gray differences among three groups were compared by SPM5 software and voxel-based analysis.Results In conventional MRI,abnormal lesions were detected in 3 CDF patients.In DTI,compared to non-CDF group,CDF patients showed significantly increased apparent diffusion coefficient (ADC) values in right precuneus and brodmann area 6,21 (P ＜0.01).No difference of fractional anisotropy (FA) was found between these two groups.Compared to health controls,CDF patients showed significantly decreased FA values in right parahippocampa gyrus,cerebellar tonsil and pons (P ＜ 0.01),and increased ADC values in right superior frontal gyrus,cuneus,middle temporal gyrus,insula,brodmann area (13,20,21,27,30,47),and left middle frontal gyrus,brodmann area 10,cingulate gyrus and corpus callosum (P ＜0.01).Compared to health controls,non-CDF patients showed significantly increased ADC values in right parahippocampa gyrus,superior frontal gyrus,brodmann area (10,25),left middle temporal gyrus,middle occipital gyrus,brodmann area (3,13,19,25),bilateral insula and corpus callosum (P ＜ 0.01),and no difference of FA.Conclusions DTI is more sensitive to detect white matter impairment of cognitive dysfunction in SLE patients than conventional MRI.
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Objective To investigate the white matter injury in patients with systemic lupus erythematosus (SLE) combined with cognitive dysfunction by diffusion tensor imaging (DTI).Methods The Montreal cognitive assessment,conventional magnetic resonance imaging (MRI) and DTI were performed in 11 SLE patients with cognitive dysfunction (CDF),11 SLE patients without cognitive dysfunction (nonCDF) and 10 health controls.Local gray differences among three groups were compared by SPM5 software and voxel-based analysis.Results In conventional MRI,abnormal lesions were detected in 3 CDF patients.In DTI,compared to non-CDF group,CDF patients showed significantly increased apparent diffusion coefficient (ADC) values in right precuneus and brodmann area 6,21 (P ＜0.01).No difference of fractional anisotropy (FA) was found between these two groups.Compared to health controls,CDF patients showed significantly decreased FA values in right parahippocampa gyrus,cerebellar tonsil and pons (P ＜ 0.01),and increased ADC values in right superior frontal gyrus,cuneus,middle temporal gyrus,insula,brodmann area (13,20,21,27,30,47),and left middle frontal gyrus,brodmann area 10,cingulate gyrus and corpus callosum (P ＜0.01).Compared to health controls,non-CDF patients showed significantly increased ADC values in right parahippocampa gyrus,superior frontal gyrus,brodmann area (10,25),left middle temporal gyrus,middle occipital gyrus,brodmann area (3,13,19,25),bilateral insula and corpus callosum (P ＜ 0.01),and no difference of FA.Conclusions DTI is more sensitive to detect white matter impairment of cognitive dysfunction in SLE patients than conventional MRI.
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Objective To explore the changes of urine albumin-creatinine ratio ( ACR) and urina-ry podocalyxin (PCX) and the relationship of score of Montreal cognitive assessment (MoCA) with urine ACR and PCX in patients with type 2 diabetic mild cognitive impairment. Methods Sixty patients with type 2 diabetes mellitus were used as the control group, and 60 patients with type 2 diabetic mild cognitive impairment as the mild cognitive impairment ( MCI) group. The sex, age, and course of disease and years of education of patients were recorded, the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), sys-tolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , total cholesterol ( TC) , low density lipoprotein ( LDL) , high-density lipoprotein ( HDL) , and urine ACR and PCX were measured, and the score of MoCA was assessed. Results The patients with type 2 diabetic nephropathy in the MCI group were significantly more than the control group (χ2 =73. 818,P<0. 01). The score of MoCA of the MCI group was significantly lower than the control group (P<0. 01), while urine ACR and PCX were high-er than the control group (P<0. 01). The score of MoCA was inversely associated with the urine ACR (r=-0. 868,P<0. 01) and PCX (r= -0. 785,P<0. 01), and those were the independent risk factors for the score of MoCA ( P<0. 01 ) . Conclusions The urine ACR and PCX were closely related to the cognitive function of type 2 diabetes mellitus, which can be used as the screening indexes of type 2 diabetic mild cog-nitive impairment.
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Objective To investigate the effect of cardiopulmonary bypass cardiac surgery on postoperative cognitive function of patients who wre undergoing selective cardiac surgery.Methods Fifty children patients who were scheduled for cardiac surgery were investigated with C-WISC (Chinese revised Wechsler Intelligence Scales for children) preoperative.The children patients were tested at the 7th day and 1 month postoperative by C-WISC and digital span.It could be defined postoperative cognitive dysfunction (POCD) if the C-WISC score decreased 1 SD (standard deviation).Results The incidence of POCD at the 7th day and in the first month postoperative was 40％,and 20％ in pediatric patients who underwent cardiopulmonary bypass surgery.It shows that ascending aorta clip time and cardiopulmonary bypass (CBP)time had negative correlation with intelligence quotient (IQ) (P ＜0.05),but age and education had not any correlation with intelligence quotient in pediatric patients who underwent cardiopulmonary bypass surgery (IQ) (P ＞ 0.05).Conclusions The occurrence of POCD in cardiac surgery children underwent CPB tend to be high,with long time CPB and aortic clip were more likely to have postoperative dysfunction.It shows a close relationship between CPB and aortic clip with POCD.Age and education had no significant influence on postoperative cognitive dysfunction in CPB cardiac surgery children.