Department of Neurology, Jinzhou Medical University, Jinzhou, China.
Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.
Brain Behav. 2024 May;14(5):e3526. doi: 10.1002/brb3.3526.
This study investigated the correlation between the pulsatility index (PI) of the middle cerebral artery with the total burden of cerebral small vessel disease and cognitive impairment.
Information on patients hospitalized in the Department of Neurology was collected retrospectively. These patients had complete clinical and laboratory data. The middle cerebral artery PI was measured using transcranial Doppler, a Mini-Mental State Examination (MMSE) was used to assess cognitive function, and the total cerebral small vessel disease burden was assessed using magnetic resonance imaging. Patients were grouped according to their scores for total imaging burden of cerebral small vessel disease and cognitive function. Logistic regression analysis assessed the association between the PI, total imaging burden, and cognitive impairment. Spearman analysis was used to evaluate the correlation between the PI and total imaging burden and cognitive impairment, and receiver operating characteristic (ROC) curves were used to determine the predictive value of the PI for cognitive function.
The PI was higher in the cognitive impairment (CI) group than in the no-CI group. Binary logistic regression analysis showed that increased PI was an independent risk factor for CI (OR = 1.582; 95% CI: 1.043-2.401; p = .031) and total imaging burden (OR = 1.842; 95% CI: 1.274-2.663; p = .001). Spearman analysis found that the PI correlated negatively with the MMSE score (r = -.627, p < .001). ROC curve analysis showed the PI predicted CI with an area under the curve of 0.784. The PI combined with the total imaging burden predicted CI in cerebral small vessel disease with an area under the curve of 0.832.
An increased PI was associated with CI and a high imaging burden in cerebral small vessel disease patients. The PI combined with the total burden score shows a high predictive value for CI.
本研究旨在探讨大脑中动脉搏动指数（PI）与脑小血管病总负荷及认知障碍的相关性。
回顾性收集神经内科住院患者的信息，这些患者具有完整的临床和实验室数据。使用经颅多普勒测量大脑中动脉 PI，采用简易精神状态检查（MMSE）评估认知功能，采用磁共振成像评估脑小血管病总负荷。根据脑小血管病总负荷和认知功能评分将患者分为两组。采用 Logistic 回归分析评估 PI、总成像负荷与认知障碍之间的关系。采用 Spearman 分析评估 PI 与总成像负荷和认知障碍之间的相关性，采用受试者工作特征（ROC）曲线确定 PI 对认知功能的预测价值。
认知障碍（CI）组的 PI 高于无 CI 组。二元逻辑回归分析显示，PI 升高是 CI 的独立危险因素（OR=1.582；95%CI：1.043-2.401；p=0.031）和总成像负荷（OR=1.842；95%CI：1.274-2.663；p=0.001）。Spearman 分析发现 PI 与 MMSE 评分呈负相关（r=-.627，p<0.001）。ROC 曲线分析显示，PI 预测 CI 的曲线下面积为 0.784。PI 联合总成像负荷预测脑小血管病 CI 的曲线下面积为 0.832。
PI 升高与脑小血管病患者的 CI 和高成像负荷有关。PI 联合总负荷评分对 CI 具有较高的预测价值。
