Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
PLoS One. 2022 Feb 4;17(2):e0263525. doi: 10.1371/journal.pone.0263525. eCollection 2022.
Atherosclerosis is an important risk factor for cognitive decline. This study aimed to investigate the relationship of ankle-brachial pressure index (ABI) and brachial-ankle pulse wave velocity (baPWV) with cognitive function in patients with lacunar infarction. We included records of consecutive patients with their first-ever acute stroke and a diagnosis of lacunar infarction through magnetic resonance imaging (MRI) from July 1, 2011 to December 31, 2018. We excluded patients diagnosed with dementia, including strategic single-infarct dementia, before or after stroke onset. Moreover, we excluded patients with one or more microbleeds, severe white matter lesions, or severe medial temporal atrophy on MRI. For ABI, we used the lower ankle side and divided the results into ABI < 1.0 and ABI ≥ 1.0. For baPWV, we used the higher ankle side and divided the results into two groups based on the median value of the participants. We analyzed 176 patients with stroke (age 72.5 ± 11.4 years, 67 females). The median score on the Mini-Mental State Examination (MMSE) was 27. The number of patients with ABI < 1.0 was 19 (10.8%). Univariate analysis revealed that the MMSE score was associated with age, body mass index, education, chronic kidney disease, periventricular hyperintensity, and ABI < 1.0 (p < 0.10), but not baPWV. Multivariate analysis revealed that body mass index (p = 0.039) and ABI < 1.0 (p = 0.015) were independently associated with the MMSE score. For patients with lacunar infarction, a lower ABI, but not a higher PWV, was associated with cognitive decline.
动脉粥样硬化是认知能力下降的一个重要危险因素。本研究旨在探讨踝臂血压指数（ABI）和肱踝脉搏波速度（baPWV）与腔隙性梗死患者认知功能的关系。我们纳入了 2011 年 7 月 1 日至 2018 年 12 月 31 日通过磁共振成像（MRI）诊断为首次急性中风和腔隙性梗死的连续患者的记录。我们排除了在中风前后被诊断为痴呆症（包括策略性单梗死性痴呆症）的患者。此外，我们排除了 MRI 上有一个或多个微出血、严重的白质病变或严重的内侧颞叶萎缩的患者。对于 ABI，我们使用了较低的脚踝侧，并将结果分为 ABI<1.0 和 ABI≥1.0。对于 baPWV，我们使用了较高的脚踝侧，并根据参与者的中位数将结果分为两组。我们分析了 176 名中风患者（年龄 72.5±11.4 岁，67 名女性）。简易精神状态检查（MMSE）的中位数评分为 27 分。ABI<1.0 的患者有 19 人（10.8%）。单变量分析显示，MMSE 评分与年龄、体重指数、教育程度、慢性肾脏病、脑室周围高信号和 ABI<1.0 相关（p<0.10），但与 baPWV 无关。多变量分析显示，体重指数（p=0.039）和 ABI<1.0（p=0.015）与 MMSE 评分独立相关。对于腔隙性梗死患者，较低的 ABI，而不是较高的 PWV，与认知能力下降相关。
