The impacts of white matter ischemic lesions in different regions on cognitive domains / 中华老年医学杂志

ABSTRACT

Objective To study the impacts of white matter ischemic lesions in various regions on the different cognitive domains of the patients. Methods 120 patients with white matter ischemic lesions were divided into subcortex,semi oval center,peri-ventricle,mixed regions according to MRI imaging (n=30 cases for each group). The 30 healthy control subjects were enrolled.Cognitive functions were evaluated by mini mental status scale (MMSE), montreal cognitive assessment (MOCA),object memory test (FOM),rapid verbal retrieve (RVR),block design (BD)and digit span (DS). Results The score of language in subcortical group (0.36±0.49) was lower than in control group (1.00±0.00) (P=0.011).There was no significant difference in RVR scores between mixed regions group and peri- ventricle group [(27.00 ± 9.22) vs. (32.30 ± 7.78) P =0.067],while RVR scores in mixed regions group (27.00± 9.22) were increased as compared with subcortex,semi oval center and control groups [(38.21±11.93),(35.94=9.53) and (37.00±3.16),respectively] (F=3.462,P=0.013).There was no difference,in BD scores between mixed regions group and semi- oval center group [(21.20± 9.21) vs.(25.63±12.10).P 0.070] but the mixed group scores were decreased as compared with subcortex, peri-ventricle, control groups [(37.14±10.43),(36.80± 14.27),(40.30±6.29),F=7.795,P=0.000].The scores of immediate verbal memory,calculation,short-term memory,visual spatial ability and executive were reduced in mixed regions group than in other groups (P=0.034,0.030,0.016,0.000).There was no difference in orientation score in MOCA and MMSE among the groups (P=0.256 and P=0.325).Conclusions Ischemic white matter lesions may lead to cognitive impairments depending on different region lesions. The obvious impact of peri-ventricle lesion is on memory, subcortex lesion on language,semi-oval center lesion on recognition and construction of images,while wide range of cognitive impairment may be attributed to the lesion in mixed regions.The scale of the MOCA is helpful and sensitive for identifying the presence of early cognitive impairment.