Association between cerebral blood hypoperfusion and cognitive impairment in patients with asymptomatic middle cerebral artery stenosis / 中华神经科杂志

ABSTRACT

Objective:To investigate the association between cerebral hypoperfusion and cognitive function decline in patients with asymptomatic middle cerebral artery stenosis.Methods:Sixty patients with moderate or severe stenosis of middle cerebral artery were diagnosed by magnetic resonance angiography (MRA) in the Department of Neurology, Henan Provincial People′s Hospital from November 2017 to November 2018. All patients were divided into perfusion weighted imaging (PWI) normal group （ n=14）, PWI compensated group ( n=26) and PWI decompensated group ( n=20) according to the results of PWI of magnetic resonance imaging. All patients were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MoCA). Results:The cognitive scores of the PWI decompensated group (MMSE score 19.35±3.26; MoCA score 16.06±2.59) were significantly lower than the PWI normal group (MMSE score 26.29±3.12; MoCA score 24.27±2.85) and the PWI compensated group (MMSE score 23.78±1.77; MoCA score 20.69±2.73), and the differences were statistically significant ( F=5.257, 4.134; P<0.05). The visual space and executive ability, language, delayed recall in the PWI compensated group (3.27±0.97, 1.45±0.73, 2.47±1.73, respectively) and the PWI decompensated group (1.96±0.79, 0.97±0.59, 1.49±1.38, respectively) were significantly lower than those of the PWI normal group (4.25±1.29, 2.57±1.24, 3.57±1.51, respectively), and the differences were statistically significant ( F=6.371,5.394,4.989, P<0.05). Patients in the PWI decompensated group had atrophy in the narrow hemisphere. Conclusion:Low cerebral perfusion induced by asymptomatic moderate-to-severe stenosis of the middle cerebral artery is associated with extensive cognitive impairment and local brain atrophy.