Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100050, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100050, China.
Biomed Environ Sci. 2018 Nov;31(11):797-804. doi: 10.3967/bes2018.107.
To investigate cognitive dysfunction in patients with carotid artery stenosis (CAS) and potential risk factors related to cognitive-especially memory-dysfunction.
Forty-seven patients with carotid artery stenosis were recruited into our study cohort. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were adopted to assess cognitive function, the Wechsler Memory Scale (WMS) to assess memory function, high-resolution MRI and enhanced ultrasound to evaluate carotid plaques, and computed tomography perfusion (CTP) imaging to evaluate intracranial blood perfusion. Single-factor analysis and multiple-factor regression analysis were used to analyze potential risk factors of cognitive impairment.
Mini-Mental State Examination test results showed that 22 patients had cognitive impairment, and MoCA test results showed that 10 patients had cognitive impairment. Analysis of various risk factors indicated that the average memory quotient of female patients was higher than that of males (P = 0.024). The cognitive and memory performance of those with an educational background above high school were significantly better than those of participants with high school or lower (P = 0.045). Patients with abnormal intracranial perfusion performed worse on the MMSE test (P = 0.024), and their WMS scores were significantly lower (P = 0.007). The MMSE scores and the memory quotients were significantly lower in patients with a history of cerebral infarction (MMSE, P = 0.047, memory quotient score, P = 0.018).
A history of cerebral infarction and abnormal cerebral perfusion are associated with decline in overall cognitive function and memory in patients with carotid stenosis. Being female and having an educational background above high school may be protective factors in the development of cognitive dysfunction.
探讨颈动脉狭窄（CAS）患者认知功能障碍及与认知功能障碍相关的潜在危险因素，尤其是记忆功能障碍。
本研究纳入了 47 例颈动脉狭窄患者。采用简易精神状态检查量表（MMSE）和蒙特利尔认知评估量表（MoCA）评估认知功能，采用韦氏记忆量表（WMS）评估记忆功能，采用高分辨率 MRI 和增强超声评估颈动脉斑块，采用计算机断层灌注成像（CTP）评估颅内血流灌注。采用单因素分析和多因素回归分析对认知障碍的潜在危险因素进行分析。
MMSE 测试结果显示，22 例患者存在认知障碍，MoCA 测试结果显示，10 例患者存在认知障碍。对各种危险因素进行分析，结果显示女性患者的平均记忆商数高于男性（P=0.024）。受教育程度在高中以上的患者认知和记忆能力明显优于高中及以下的患者（P=0.045）。颅内灌注异常的患者在 MMSE 测试中的表现更差（P=0.024），其 WMS 评分明显较低（P=0.007）。有脑梗死病史的患者 MMSE 评分和记忆商数明显降低（MMSE，P=0.047，记忆商数评分，P=0.018）。
脑梗死病史和异常脑灌注与颈动脉狭窄患者整体认知功能和记忆功能下降有关。女性和受教育程度在高中以上可能是认知功能障碍发展的保护因素。
