Cognitive impairment in two subtypes of a single subcortical infarction  

作　　者：Tang Yang Qiao Deng Shuai Jiang Yu-Ying Yan Ye Yuan Si-Miao Wu Shu-Ting Zhang Jia-Yu Sun Bo Wu 

机构地区：[1]Department of Neurology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China [2]Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China [3]Department of Radiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China

出　　处：《Chinese Medical Journal》2021年第24期2992-2998,共7页中华医学杂志（英文版）

基　　金：supported by grants from the 1·3·5 project for disciplines of excellence,Clinical Research Incubation Project,West China Hospital,Sichuan University(No.2020HXFH012);the National Natural Science Foundation of China(Nos.82071320 and 81870937)。

摘　　要：Background:Single subcortical infarction(SSI)is caused by two main etiological subtypes,which are branch atheromatous disease(BAD)and cerebral small vessel disease(CSVD)-related SSI.We applied the Beijing version of the Montreal Cognitive Assessment(MoCA-BJ),the Shape Trail Test(STT),and the Stroop Color and Word Test(SCWT)to investigate the differences in cognitive performance between these two subtypes of SSI.Methods:Patients with acute SSIs were prospectively enrolled.The differences of MoCA-BJ,STT,and SCWT between the BAD group and CSVD-related SSI group were analyzed.A generalized linear model was used to analyze the associations between SSI patients with different etiological mechanisms and cognitive function.We investigated the correlations between MoCA-BJ,STT,and SCWT using Spearman’s correlation analysis and established cut-off scores for Shape Trail Test A(STT-A)and STT-B to identify cognitive impairment in patients with SSI.Results:This study enrolled a total of 106 patients,including 49 and 57 patients with BAD and CSVD-related SSI,respectively.The BAD group performances were worse than those of the CSVD-related SSI group for STT-A(83[60.5-120.0]vs.68[49.0-86.5],P=0.01),STT-B(204[151.5-294.5]vs.153[126.5-212.5],P=0.015),and the number of correct answers on Stroop-C(46[41-49]vs.49[45-50],P=0.035).After adjusting for age,years of education,National Institutes of Health Stroke Scale and lesion location,the performance of SSI patients with different etiological mechanisms still differed significantly for STT-A and STT-B.Conclusions:BAD patients were more likely to perform worse than CSVD-related SSI patients in the domains of language,attention,executive function,and memory.The mechanism of cognitive impairment after BAD remains unclear.

关 键 词：BRAIN Cognitive impairment Cerebral small vessel disease Subcortical infarction STROKE 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R743.3[医药卫生—临床医学]