Zuo Lijun, Dong YanHong, Hu Yang, Xiang Xianglong, Liu Tao, Zhou Jianxin, Shi Jiong, Wang Yongjun
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore.
Neuropsychiatr Dis Treat. 2023 May 11;19:1171-1180. doi: 10.2147/NDT.S384726. eCollection 2023.
Stroke has been considered to raise the risk of dementia in several studies, but the relationship between brain structural changes and poststroke cognitive impairment (PSCI) is unclear.
In this study, 23 PSCI patients with basal ganglia infarcts after 2 weeks and 29 age-matched controls underwent magnetic resonance imaging measuring cortical thickness and volume changes, as well as neuropsychological tests. CI was derived from a performance score <1.5 standard deviations for normally distributed scores. We compared scores in different cognitive domains and cortical thickness and volumes in two groups. Multiple linear regressions were used to investigate the relationship between cortical thickness and volumes and neuropsychological tests.
A majority of PSCI patients were in their 50s (55.19±8.52 years). PSCI patients exhibited significantly decreased scores in multiple domains, such as memory, language, visuomotor speed, and attention/executive function. The volumes of the middle posterior corpus callosum, middle anterior corpus callosum, and hippocampus in PSCI patients were markedly lower than controls. The thickness of the right inferior temporal cortex and insula were significantly smaller than controls. It found that the reduced right hippocampus was related to executive dysfunction. Hippocampus dysfunction may be involved in language impairment (<0.05) in PSCI patients with basal ganglia infarcts.
These findings demonstrated that brain structure changed after ischemic stroke, and different gray-matter structural changes could lead to specific cognitive decline in PSCI patients with basal ganglia infarcts. Atrophy of the right hippocampus potentially serves as an imaging marker of early executive function of PSCI.
多项研究认为中风会增加患痴呆症的风险，但脑结构变化与中风后认知障碍（PSCI）之间的关系尚不清楚。
在本研究中，23例基底节梗死2周后的PSCI患者和29例年龄匹配的对照组接受了磁共振成像，测量皮质厚度和体积变化，以及神经心理学测试。认知障碍由正态分布分数的表现得分<1.5个标准差得出。我们比较了两组在不同认知领域的得分以及皮质厚度和体积。采用多元线性回归研究皮质厚度和体积与神经心理学测试之间的关系。
大多数PSCI患者为50多岁（55.19±8.52岁）。PSCI患者在多个领域的得分显著降低，如记忆、语言、视觉运动速度和注意力/执行功能。PSCI患者的胼胝体中后部、胼胝体中前部和海马体的体积明显低于对照组。右侧颞下回皮质和岛叶的厚度明显小于对照组。发现右侧海马体缩小与执行功能障碍有关。海马体功能障碍可能参与基底节梗死的PSCI患者的语言障碍（<0.05）。
这些发现表明缺血性中风后脑结构发生了变化，不同的灰质结构变化可能导致基底节梗死的PSCI患者出现特定的认知衰退。右侧海马体萎缩可能是PSCI早期执行功能的影像学标志物。
