Predictors of post-stroke cognitive impairment / 国际脑血管病杂志

Post-stroke cognitive impairment (PSCI) refers to the decline of cognitive function after stroke, including mild cognitive impairment and dementia. It is very important to prevent PSCI, and it is a direction worth exploring to find the predictors. This article reviews the research progress of the predictors of PSCI, including demographic characteristics, imaging characteristics of stroke onset, stroke itself characteristics, and molecular markers, hoping to help screen high-risk patients and intervene in time to delay the occurrence and development of PSCI.

Relationship between 24 h ambulatory blood pressure and severity of white matter hyperintensities / 国际脑血管病杂志

Objective To investigate the correlation between 24 h ambulatory blood pressure monitoring (ABPM) parameters and white matter hyperintensities (WMHs).Methods A cross-sectional analysis was performed in patients who visited the Department of Neurology,Liaoning People's Hospital,and showed WMHs on the head MRI and completed 24 h ABPM in the same period of hospitalization from September 2016 to October 2018.Periventricular white matter hyperintensities (PVWMHs) and deep white matter hyperintensities (DWMHs) were evaluated using the modified Scheltens scale respectively,and the sum of the two was used as the overall severity score of WMHs.The enrolled patients were grouped according to the tertiles of the overall WMH score.Multivariate ordinal logistic regression analysis was used to investigate independent risk factors affecting overall WMH scores.Multivariate linear regression analysis was used to investigate the influencing factors of PVWMH and DWMH scores.Results A total of 201 patients were enrolled,aged (62.7 ± 10.3) years (range 45-88 years),82 males (40.8％),and 123 patients (61.2％) with hypertension.The total WMH scores were 1-27.According to the tertiles,64 patients (31.8％) were divided into lower tertile group (1-3),65 (32.3％) in the middle tertile group (4-8),and 72 (35.8％) in the higher tertile group (9-27).There was significant difference in age between any two WMH score groups,namely,the high tertile group ＞ middle tertile group ＞ low tertile group (69.5 ± 8.5 years vs.63.1 ±9.2 years vs.54.5 ±6.9 years;all P＜0.001).The proportion of hypertension in the middle tertile group (66.2％) and the higher tertile group (69.4％) were significantly higher than those in the lower tertile group (46.9％;all P＜0.05).The homocysteine in the higher tertile group was significantly higher than that in the lower tertile group (15.6 [12.7-19.7]μmol/Lvs.14.1[12.5-15.9]μmol/L;P ＜0.05).In terms of 24 h ABPM parameters,the 24 h mean systolic blood pressure (24 h SBP) in the higher tertile group was higher than that in the lower tertile group,and the nighttime mean systolic blood pressure (nSBP) level in the higher tertile group was higher than that in the lower and middle tertile groups,the SD of daytime systolic blood pressure (dSBPSD) and the SD of the nighttime systolic blood pressure (nSBPSD) in the higher tertile group were higher than those in the lower tertile group,and dSBPSD of the middle tertile group was higher than of the lower tertile group.The above differences were statistically significant (all P ＜0.05).Multivariate ordinal logistic regression analysis showed that the increased age (odds ratio[OR] 1.143,95％ confidence interval[CI] 1.104-1.185;P＜0.001),24 h SBP (OR 1.026,95％ CI 1.005-1.048;P =0.015),dSBP (OR 1.022,95％ CI 1.001-1.043;P =0.036),nSBP (OR 1.026,95％ CI 1.006-1.046;P=0.011),dSBPSD (OR 1.119,95％ CI 1.023-1.221;P=0.013),and nSBPSD (OR 1.107,95％ CI 1.022-1.200;P=0.013) were independently positively correlated with the overall WMH score.Multivariate linear regression showed that age (β=0.607,95％ CI 0.500-0.714;P＜0.001),24 h SBP (β=0.182,95％ CI 0.075-0.289;P=0.001),dSBP (β=0.156,95％ CI 0.049-0.264;P=0.004),and nSBP (β =0.200,95％ CI 0.092-0.307;P ＜0.001) were independently positively correlated with the PVWMH score;age (β =0.505,95％ CI 0.387-0.622;P ＜0.001),24 h SBP (β =0.132,95％ CI 0.015-0.248;P =0.027),dSBP (β =0.127,95％ CI0.011-0.243;P =0.032),nSBP (β =0.148,95％ CI 0.031-0.265;P =0.013),and nSBPSD (β =0.133,95％ CI 0.016-0.250;P=0.027) were independently positively correhted with the DWMH score.Conclusion The increased age,ambulatory systolic blood pressure level (24 h,daytime,nighttime) and systolic blood pressure variability level (dSBPSD and nSBPSD) were independently associated with the severity of WMHs.

Total magnetic resonance imaging burden of cerebral small vessel diseases and its application / 中华神经科杂志

Imaging findings of cerebral small vessel diseases (CSVD) include white matter lesions,enlarged perivascular spaces,lacunar infarcts and cerebral microbleeds.These imaging markers often appear at the same time.In recent years,the "total small vessel diseases score" was proposed by combining the different magnetic resonance imaging (MRI) markers into one measure of CSVD,so that we can capture all the brain damage from CSVD more accurately through the evaluation of total MRI burden.This paper reviews the research progress of total small vessel diseases score and its application.

Cerebral microbleeds, atrial fibrillation and stroke prevention / 国际脑血管病杂志

Cerebral microbleeds (CMBs) are a imaging manifestation of small vessel disease, and have a marked impact on the recurrence and on hemorrhagic transformation of ischemic stroke. Atrial fibrillation (AF) is a common arrhythmia,w hich significantly increases the risk of stroke,and the incidence of CMB in AF patients is also significantly higher than that in non-AF patients.Antithrombotic therapy is the cornerstone of stroke prevention,but it also increases the risk of bleeding.The benefit of stroke prevention and the bleeding risk should be assessed in AF patients w ith CMBs.

Cerebral small vessel disease and cognitive impairment / 国际脑血管病杂志

Cerebral small vessel disease is a common cerebrovascular disease in clinical practice.It is mainly characterized by insidious onset and slow development.Some may have acute attack.The imaging features of cerebral small vessel disease mainly include cerebral white matter lesions,lacunar infarction,cerebral microbleed and cerebral perivascular space expansion.It is closely associated with cognitive impairment.All imaging findings can occur simultaneously and interact,further aggravate cognitive impairment,and ultimately lead to dementia.Therefore,the influence of cerebral small vessel disease on the quality of life and social function of the patients cannot be ignored.

Effect of DNA vaccine on behavior and brain Aβ deposition in Alzheimer's disease transgenic mice / 中华行为医学与脑科学杂志

Objective To study on the effect of DNA vaccine, p(Aβ3-10) 10-mIL-4, immunization on behavior and brain Aβ deposition in APP/PS1 transgenic mice.Methods DNA vaccine p(Aβ3-10) 10-mIL-4 was constructed which expressed fusion protein of ten tandem repeats of Aβ3-10 and mouse IL-4.APP/PS1 transgenic mice were vaccinated with p (Aβ3-10) 10-mIL-4.Aβ42 peptide and pcDNA3.1 (+) were injected to the control groups.Anti-Aβ antibody titers were detected before and after vaccination by enzyme-linked immunosorbent assay (ELISA) ,the spatial learning and memory ability of the mice were evaluated by Morris water maze.The senile plaques in mouse brains were detected by immunohistochemistry.Results Compare with pcDNA3.1 (+) group,immunization with the vaccine p (Aβ3-10) 10-mIL-4 in APP/PS1 mice induced high-titer Anti-Aβ antibodies ((27.49±4.51) μg/ml, P＜0.01) ,decreased Aβ deposition (reduced senile plaque number in the cortex and hippocampus by 52.86％ and 58.29％ respectively, P＜0.01) and improved their cognitive ability.Conclusions The immunization with p(Aβ3-10)10-mIL-4 in APP/PS1 mice achieve an ideal effect of vaccination, and p(Aβ3-10) 10-mIL-4 can be an alternative Alzheimer's disease vaccine to further study.