ABSTRACT
Objective:To explore the effect of cognitive-motor dual task training on vascular mild cognitive impairment (VaMCI) in old patients. Methods:From March to September, 2019, 76 old patients with VaMCI in three general hospitals were divided into control group (n = 38) and intervention group (n = 38). All the patients accepted health education, while the intervention group accepted cognitive-motor dual task training in addition, for three months. They were assessed with Montreal Cognitive Assessment-Beijing Version (MoCA-BJ) and Trail Making Test (TMT-A) before and after intervention, and the one-year incidence of fall before and after intervention was investigated in the intervention group. Results:Two cases in the control group and three cases in the intervention group dropped down. The total score and dimension scores of MoCA-BJ were more significantly in the intervention group than in the control group after intervention (|Z| > 2.002, P < 0.05), except the dimension of naming, while the time for TMT-A was significantly less (Z = -5.949, P < 0.001). The one-year incidence of fall decreased significantly during the year after intervention (χ2 = 10.080, P < 0.01). Conclusion:Cognitive-motor dual task training can improve the cognitive function of older VaMCI patients, especially for attention and executive function, and reduce the risk of fall.
ABSTRACT
Subcortical vascular mild cognitive impairment (svMCI) is a common prodromal stage of vascular dementia. Although mounting evidence has suggested abnormalities in several single brain network metrics, few studies have explored the consistency between functional and structural connectivity networks in svMCI. Here, we constructed such networks using resting-state fMRI for functional connectivity and diffusion tensor imaging for structural connectivity in 30 patients with svMCI and 30 normal controls. The functional networks were then parcellated into topological modules, corresponding to several well-defined functional domains. The coupling between the functional and structural networks was finally estimated and compared at the multiscale network level (whole brain and modular level). We found no significant intergroup differences in the functional–structural coupling within the whole brain; however, there was significantly increased functional–structural coupling within the dorsal attention module and decreased functional–structural coupling within the ventral attention module in the svMCI group. In addition, the svMCI patients demonstrated decreased intramodular connectivity strength in the visual, somatomotor, and dorsal attention modules as well as decreased intermodular connectivity strength between several modules in the functional network, mainly linking the visual, somatomotor, dorsal attention, ventral attention, and frontoparietal control modules. There was no significant correlation between the altered module-level functional–structural coupling and cognitive performance in patients with svMCI. These findings demonstrate for the first time that svMCI is reflected in a selective aberrant topological organization in multiscale brain networks and may improve our understanding of the pathophysiological mechanisms underlying svMCI.
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 observe the efficacy of folic acid combined with mecobalamine for the treatment of vascular mild cogni-tive impairment (VMCI) in patients with cerebral small vessel disease (SVD) and hyperhomocysteinemia(Hcy) .Methods A total of 84 VMCI patients with cerebral small vessel disease and Hcy were randomly divided into combination group and control group . Two groups received conventional therapy for 6 months .Besides ,the combination group received folic acid combined with mecobal-amin .The level of plasma Hcy and ADAS-cog score were observed before and after 3 months and 6 months treatment .Results Af-ter treatment ,plasma Hcy significantly lower in the combination group (P0 .05) .However ,after 6 months treatment ,the ADAS-cog scores decreased obviously than that in the before treatment group (P0 .05) .After 3 months treatment ,there was no significant difference on ADAS-cog score between combination group and control group (P>0 .05) ,however ,there had significant difference between the two groups after 6 months treatment(P<0 .05) .Conclusion The level of plasma Hcy could be reduced by adding folic acid and mecobalamin .Treatment of hyperhomocysteinemia may delay the progression of vascular cognitive impairment w hich caused by cerebral small vessel disease .
ABSTRACT
This study was aimed to observe clinical efficacy of Bushen Huoxue Kaiqiao (BSHXKQ) treatment of diabetes-induced vascular mild cognitive impairment . A total of 30 cases of diabetes-induced vascular mild cognitive impairment were randomly divided into the treatment group ( 15 cases ) and the control group ( 15 cas-es). The treatment group received free-fried BSHXKQ prescription (Cistanche 10 g, Shichangpu 5 g, Sanqi 2 . 5 g ) for treatment 3 times a day , and in combination of 30 mg of nimodipine , 3 times a day . In the con-trol group , 30 mg of nimodipine was orally administrated 3 times a day . The treatment was continued for 6 months. Clinical Dementia Rating (CDR), Activity of Daily Living Scale (ADL), Montreal Cognitive Assessment Beijing Edition ( MoCA ) and TCM Syndrome Score were used in the evaluation before and after the treatment . The results showed that the rate of progress was in both groups after treatment . In the treatment group , the rate was 86 . 70%, and in the control group the rate was 33 . 33%. The total effective rate in the treatment group was superior to the control group ( P < 0 . 05 ) . There were statistical significances in the MoCa Scale , ADL Scale and TCM Syndrome Score before and after treatment in each group ( P < 0 . 05 ) . The treatment ef-fect in the treatment group was superior to the control group ( P < 0 . 05 ) . There was no statistical significance in the incidence of adverse events in both groups . It was concluded that the effect of BSHXKQ prescription in the treatment of diabetes-induced vascular mild cognitive impairment was superior to nimodipine in improving activities of daily living , cognitive function , degree of dementia and TCM syndrome score . There was no differ-ence in the incidence of adverse events compared with nimodipine .
ABSTRACT
BACKGROUND AND PURPOSE: The most important treatment for subcortical vascular dementia (SVaD) is controlling the blood pressure (BP). However, the few studies that have investigated the relationships between diurnal BP rhythm and subcortical ischemic vascular cognitive impairment have produced inconclusive results. In the study presented here, the 24-hour BP values of three groups of subjects-patients with subcortical vascular mild cognitive impairment (SvMCI), patients with SVaD, and normal controls-were compared using working criteria and 24-hour ambulatory BP (ABP) monitoring. METHODS: The subjects (42 patients with SVaD, 37 patients with SvMCI, and 30 controls) were selected according to the study's inclusion/exclusion criteria. All subjects underwent brain magnetic resonance (MR) imaging and MR angiography, detailed neuropsychological testing, and 24-hour ABP monitoring. RESULTS: The prevalence of nondippers differed markedly between the control group and both the SVaD and SvMCI groups. Loss of nocturnal dipping was significantly associated with SVaD [odds ratio (OR), 4.827; 95% confidence interval (CI), 1.07-12.05]. CONCLUSIONS: It was found that SVaD is associated with loss of nocturnal BP dipping combined with increased pulse pressure and systolic BP (SBP) variability. Correction of these factors could therefore be important in the prevention of SVaD, independent of measures used to reduce BP.