Liang Fei-Fei, Liu Xiao-Xia, Liu Jiang-Hong, Gao Yang, Dai Jian-Guo, Sun Zi-Hui
Department of Geriatrics, Zhangjiakou First Hospital in Hebei Province, Zhangjiakou 075000, Hebei Province, China.
The Fourth Ward, Zhangjiakou Infectious Disease Hospital, Zhangjiakou 075000, Hebei Province, China.
World J Psychiatry. 2024 Aug 19;14(8):1190-1198. doi: 10.5498/wjp.v14.i8.1190.
The aging of the population has become increasingly obvious in recent years, and the incidence of cerebral infarction has shown an increasing trend annually, with high death and disability rates.
To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.
Between January 2020 and December 2023, we treated 98 cases of elderly acute insula, patients with cerebral infarction in the cerebral infarction acute phase (3-4 weeks) and for the course of 6 months in Montreal Cognitive Assessment Scale (MoCA) for screening of cognition. Notably, 58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group, respectively. In patients with cerebral infarction, magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions, the relationship between the parts of the infarction volume, and analysis of acute insula cognitive disorder in elderly patients with cerebral infarction and the relationship between the two.
The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment ( < 0.05). The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group, and the difference was statistically significant ( < 0.05). The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group ( < 0.05). In the cognitive impairment group, the infarct volumes in the basal ganglia, thalamus, and mixed lesions were negatively correlated with the total MoCA score, with correlation coefficients of -0.67, -0.73, and -0.77, respectively.
In elderly patients with acute insular infarction, infarction in the basal ganglia, thalamus, and mixed lesions were more likely to lead to cognitive dysfunction than in other areas, and patients with large infarct volumes were more likely to develop cognitive dysfunction. The infarct volume in the basal ganglia, thalamus, and mixed lesions was significantly negatively correlated with the MoCA score.
近年来，人口老龄化日益明显，脑梗死的发病率呈逐年上升趋势，且死亡率和致残率较高。
分析梗死部位和体积对老年急性岛叶脑梗死患者认知功能障碍的影响。
2020年1月至2023年12月，我们对98例老年急性岛叶脑梗死患者在脑梗死急性期（3 - 4周）进行治疗，并在6个月的病程中采用蒙特利尔认知评估量表（MoCA）进行认知筛查。值得注意的是，分别有58例和40例患者被纳入认知障碍组和无认知障碍组。对脑梗死患者采用磁共振成像进行筛查，明确分析两组不同梗死部位患者的MoCA评分、梗死体积部位之间的关系，以及老年脑梗死患者急性岛叶认知障碍与二者之间的关系。
基底节和丘脑部位有认知障碍的患者数量显著高于无认知障碍的患者（<0.05）。认知障碍组的总梗死体积高于非认知障碍组，差异有统计学意义（<0.05）。认知障碍组不同部位的梗死体积均高于非认知障碍组（<0.05）。在认知障碍组中，基底节、丘脑和混合性病变的梗死体积与MoCA总分呈负相关，相关系数分别为 -0.67、-0.73和 -0.77。
在老年急性岛叶梗死患者中，基底节、丘脑和混合性病变梗死比其他区域更易导致认知功能障碍，梗死体积大的患者更易发生认知功能障碍。基底节、丘脑和混合性病变的梗死体积与MoCA评分显著负相关。
