The Value of Brain Structural Magnetic Resonance Imaging Combined with APOE--4 Genotype in Early Diagnosis and Disease Progression of Senile Vascular Cognitive Impairment No Dementia.

OBJECTIVE

To explore the value of brain structure magnetic resonance imaging combined with APOE-4 genotype in the early diagnosis and disease progression of elderly patients with vascular cognitive impairment no dementia (VCIND).

METHODS

The first stroke patients admitted to our hospital from March 2017 to December 2018 were collected, including 130 cases of vascular cognitive impairment no dementia (VCIND group) and 50 cases of the control group (NC group). The basic information of all subjects was recorded, and APOE-4 alleles of all subjects were detected. The neuropsychological test scale evaluated the cognitive psychology of the subjects, and they were scanned by multi-parameter MRI. After follow-up, VCIND patients were divided into the dementia group and the nondementia group. MRI scans were again performed, and the risk factors of VCIND patients developing dementia were analyzed.

RESULTS

Compared with the NC group, patients in the VCIND group had shorter years of education, more patients with hypertension, higher levels of homocysteine (Hcy), and lower cognitive ability. Patients with White Matter Volume (WMV), White Matter Hyperintensity (WMH), Lacunar Infarction (LI), elevated Fazekas scores, and APOE-4 gene carriers are more likely to develop VCIND. After 12 months of follow-up, compared with the nondementia group, the number of WMV, WMH, Fazekas scores, and APOE-4 gene carriers in the dementia group was significantly increased. In addition, the progression-free survival rate of APOE-4 gene carriers was significantly lower than that of nonAPOE-4 gene carriers.

CONCLUSION

Years of education, hypertension, high levels of Hcy, elevated WMV, WMH, LI, and Fazekas scores, and carrying the APOE-4 gene are risk factors for VCIND in stroke patients. Craniocerebral structural MRI combined with APOE-4 genotype has a diagnostic role in the early diagnosis and disease progression of elderly patients with VCIND.