Association Between Cerebral Hypoperfusion and Cognitive Impairment in Patients With Chronic Vertebra-Basilar Stenosis.

Yiming Deng,Dapeng Mo,Xiaoqing Li,Chunxue Wang,Weibin Gu,Binbin Sui,Mi Shen,Lian Liu,Meifang Zhu,Luyao Wang,Zhongrong Miao,Xiaochuan Huo,Feng Gao,Ligang Song,Ning Ma,Xuan Sun,Duanduan Chen

doi:10.3389/fpsyt.2018.00455

Abstract

Objective: This study aimed to investigate the association between cognitive impairment and cerebral haemodynamic changes in patients with chronic vertebra-basilar (VB) stenosis.Methods: Patients with severe posterior circulation VB stenosis and infarction or a history of infarction for more than 2 weeks from January 2014 to January 2015 were enrolled (n = 96). They were divided into three groups, namely, the computed tomography perfusion (CTP) normal group, the CTP compensated group, and the CTP decompensated group. Cognitive function was assessed using a validated Chinese version of the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Regression models were used to identify independent risk factors for cognitive impairment.Results: The MMSE and FAB scores of patients in the CTP decompensated group were significantly lower than those of patients in the CTP normal and CTP compensated groups (all p < 0.05). The RBANS total and its domain scores, including immediate memory, visual acuity, and delayed memory, in the CTP compensated and CTP decompensated groups were significantly lower than those in the CTP normal group (all p < 0.05). Multiple regression analyses showed that CTP compensation, CTP decompensation, severe VB tandem stenosis, and multiple infarctions were independent risk factors for cognitive impairment.Conclusions: Low perfusion caused by severe VB stenosis can lead to extensive cognitive impairments in areas such as immediate memory, visual span, and delayed memory.

Highlights

Neurocognitive function changes with age [1] and disease progression [2,3,4], which is related to pathologic mechanisms and is examined clinically
This study aimed to investigate the association between cognitive impairment and cerebral haemodynamic changes in patients with chronic vertebra-basilar (VB) stenosis
Multiple regression analyses showed that computed tomography perfusion (CTP) compensation, CTP decompensation, severe VB tandem stenosis, and multiple infarctions were independent risk factors for cognitive impairment

Summary

Introduction

Neurocognitive function changes with age [1] and disease progression [2,3,4], which is related to pathologic mechanisms and is examined clinically. Carotid artery stenosis is closely related to vascular cognitive impairment (VCI) [5]. Carotid artery stenosis can directly lead to the occurrence and rapid progression of VCI and accelerate the development of degenerative diseases, such as Alzheimer’s disease [6]. Because of the collateral circulation in cerebral arteries, stenosis at the same site may cause different levels of cerebral blood flow perfusion. Studies have found that changes in cerebral flow perfusion were related to VCI in patients with carotid artery stenosis. Hypoperfusion caused by carotid artery stenosis can lead to frontal lobe damage, which in turn reduces the attention, language fluency, spatial structure, short-term memory, and executive function of patients [7]. The correlation between cerebral blood flow perfusion and VCI in patients with VB artery stenosis remains unclear

Methods

Results

Conclusion