Effect of cerebral nicrobleeds on cognitive function in patients with acute cerebral infarction： a retrospective case series study

Abstract

Objective To investigate the correlation between cognitive function and cerebral microbleeds （CMBs） in patients with acute cerebral infarction. Methods The clinical and imaging findings in patients with acute stroke were analyzed retrospective. CMBs were counted according to the findings of MRI. The general conditions, CMB site and leukoaraiosis severity of the patients were recorded in detail. The cognitive function of the patients was assessed with the Montreal cognitive assessment scale （MoCA） the next day in the hospital. MoCA assessment follow-up was conducted at 3, 6 and 9 months. The changes in cognitive function of the patients with acute cerebral infarction and its relationship with CBMs were analyzed. Results A total of 82 patients with ischemic stroke were enrolled in the study, 33 of them had CBMs and 49 had no CBMs. The systolic blood pressure （155.03 ± 19. 68 mm Hgvs. 142. 20 ± 21.22 mm Hg;t - 2. 762, P = 0. 007） and the National Institutes of Health Stroke Scale （NIHSS） score （6. 21 ± 4. 57 vs. 4. 00 ± 3.98; t =2. 322, P = 0. 023） in the CBM group were significantly higher than those in the non-CBM group. Multivariate logistic regression analysis showed that the systolic blood pressure level （odds ratio [OR] 1. 032, 95% confidence interval [CI] 1. 008 -1. 057; P=0. 009） and the NIHSS score （OR 1. 163, 95% CI 1. 013 - 1. 311; P=0. 014） were the independent predictors of CBMs in patients with acute cerebral infarction. CMBs were closely associated with MoCA scores, and the longer follow-up time, the correlation would stronger. The executive function （rs = 0. 318, P = 0. 004）, visual space ftmction （rs = 0. 403, P = 0. 000） and calculation function （rs = 0. 362, P = 0. 001 ） in patients with CMBs were significantly impaired. The more serious of CMBs, the lower of the scores in above 3 cognitive domains, and the damage would be more serious. Conclusions CMBs are closely associated with cognitive function impairment in patients with acute cerebral infarction. The more serious of CMBs, the more serious of cognitive function impairment will be, and with the extension of time, cognitive function impairment in patients with CMBs will asgravate. Key words: Stroke; Brain Ischemia; Cerebral Hemorrhage; Cognition Disorders; Magnetic Resonance Imaging