Clinical study on cognitive function in ischemic stroke patients with cerebral microbleeds / 中华神经科杂志

ABSTRACT

Objective To investigate the impact of cerebral microbleeds (CMBs) on cognitive function in ischemic stroke patients.Methods A total of 268 acute ischemic stroke patients recruited in the Ningbo First Hospital from January 2014 to June 2015 were divided into CMBs group (199 patients) and non-CMBs group (69 patients) according to whether complicated with CMBs by susceptibility-weighted imaging (SWI).According to the microbleed number, CMBs group patients were divided into 2 grades: grade 1 (1-5 CMBs) and grade 2 (≥6 CMBs). Montreal Cognitive Assessment (MoCA) was used to evaluate and compare the global cognitive function and cognitive domains of the patients. Results The total MoCA score and the scores of visuospatial/executive, attention domains in CMBs group were 20.95±4.53, 2.53±1.09, 3.83±0.97, while those in non-CMBs group were 26.82±1.25, 3.16±1.24 and 4.91±0.84. The total MoCA score and the scores of visuospatial/executive, attention domains were significantly lower in CMBs group than those in non-CMBs group (t=16.59, P<0.01;t=3.75, P<0.01;t=8.83, P<0.01). The total MoCA score and the score of attention domain in grade 1 CMBs group were 21.53±4.61 and 4.11±0.91 , which were significantly lower than those in non-CMBs group (t=14.09, P<0.01;t=14.23, P<0.01). Whereas the total MoCA score and the scores of visuospatial/executive, attention, orientation domains in grade 1 CMBs group were 21.53±4.61, 2.88±1.06, 4.11±0.91, 4.96±0.40, which were significantly higher than those in grade 2 CMBs group (18.58±3.08, 2.23±0.95, 3.63±1.01, 3.85±0.39, respectively;t=2.85, P<0.01;t=2.54, P<0.05;t=5.63, P<0.01;t=2.58, P<0.01). Multivariate regression analysis showed that independent risk factors of MoCA scores in ischemic stroke patients included CMBs (OR=3.15, 95% CI 1.28-5.12, P=0.005) and the number of CMBs (OR=1.73,95% CI 1.08-2.32,P=0.031). Conclusions CMBs and the number of CMBs were independently associated with cognitive impairment in ischemic stroke patients. And with the increasing of the microbleed number, the impairments of certain cognitive domains were more obviously.