脑小血管病患者近期皮质下小梗死与认知功能的相关性研究OACSTPCD

Objective To investigate the relationship between cognitive function and recent small subcortical in-farcts(RSSI)in patients with cerebral small vessel disease(CSVD).Methods We retrospectively consecutively in-cluded patients with CSVD confirmed by brain magnetic resonance imaging in the Department of Neurology,Peking Uni-versity First Hospital from February 2018 to September 2022.General demographic data and clinical data were collected.Cognitive function was assessed using the Mini-Mental State Examination(MMSE)and the Montreal Cognitive Assessment(MoCA).According to diffusion-weighted imaging findings,the patients were divided into RSSI group and non-RSSI group.The number and location of RSSI were recorded.The general demographic data,clinical data,and cognitive func-tion of the two groups were compared,and the relationship between RSSI imaging features and cognitive function was ana-lyzed.Results A total of 181 patients with CSVD were included,with 91 in the RSSI group and 90 in the non-RSSI group.Compared with the non-RSSI group,the RSSI group had a significantly higher body mass index(24.27±3.33 vs 25.43±3.33 kg/m2,t=2.228,P=0.027),a significantly higher systolic pressure(139.6±20.2 vs 145.3±20.2 mmHg,t=2.013,P=0.046),a significantly lower total MoCA score[24(21,27)vs 22(18.8,26),Z=-1.980,P=0.048],a significantly lower score in visuospatial and executive function[4(3,5)vs 3(2,4),Z=-2.756,P=0.006],a signifi-cantly lower score in language[2(2,3)vs 2(1,2),Z=-2.020,P=0.043],and a significantly lower score in abstrac-tion[2(1,2)vs 2(1,2),Z=-2.052,P=0.04].Compared with the non-RSSI group,patients with RSSI in the basal ganglia had a significantly lower total MoCA score[24(21,27)vs 21(17,23),Z=-2.018,P=0.044]and a signifi-cantly lower score in visuospatial and executive function[4(3,5)]vs 3(1.5,3.5),Z=-2.601,P=0.009];and pa-tients with RSSI in the brainstem had significantly lower scores in visuospatial and executive function[4(3,5)vs 3(2,4),Z=-2.325,P=0.020]and language[2(2,3)vs 2(1,2),Z=-2.338,P=0.019].Conclusion In patients with CSVD,RSSI can result in cognitive impairment,and the location of RSSI can affect the pattern of cognitive impairment.Preventing the occurrence of RSSI is important for pre-venting CSVD-related cognitive impairment.