The effect of leukoencephalopathy on cognitive function in patients with acute cerebral infarction

Abstract

Objective To investigate the effect of different parts leukoencephalopathy on cognitive function in patients with acute cerebral infarction,and analyze the relationship between injury site of cholinergic pathways and cognitive function.Methods Ninety-seven patients with acute cerebral infarction were divided into leukoencephalopathy group (59 cases) and non-leukoencephalopathy group (38 cases)according to the cranial MRI T2 scanning.The all patients of 2 groups were evaluated by cholinergic pathways hyperintensities scale (CHIPS) and reforming Scheltens scale.The cognitive function of all patients were evaluated by Montreal cognitive assessment (MoCA).The difference of the cognitive function between 2 groups was observed,and the relationship between CHIPS score,reforming Scheltens scale score and MoCA score was investigated.Results There were statistical differences in MoCA total score and visuospatial/execution,memory,attention score between leukoencephalopathy group and non-leukoencephalopathy group [(20.86 ± 4.52) scores vs.(23.47 ± 4.49) scores,(3.80 ± 1.68) scores vs.(3.11 ± 1.47) scores,(2.78 ±1.57) scores vs.(1.95 ± 1.80) scores,(4.00 ± 2.08) scores vs.(3.87 ± 2.04) scores] (P ＜ 0.01 or ＜ 0.05).There were statistical differences in CHIPS score and reforming Scheltens scale score between cognitive dysfunction group (35 cases)and non-cognitive dysfunction group (24 cases)[(47.77 ± 12.36) scores vs.(39.83 ±7.98) scores,(5.14 ± 1.73) scores vs.(2.58 ±2.10) scores] (P ＜0.01).There was negative correlation between MoCA total score and frontal periventricular score,occipital periventricular score,parietal lobe score,periventricular total score,deep alba total score and reforming Scheltens scale total score (P ＜0.01).There was negative correlation between visuospatial/execution score,attention score,fixing score,MoCA total score and CHIPS score (P ＜ 0.01).There was negative correlation between attention score,fixing score,MoCA total score and reforming Scheltens scale score (P ＜ 0.01).Conclusions In acute cerebral infarction patients leukoencephalopathy is probably related to cognitive function,and the severity of leukoencephalopathy correlates with the degree of cognitive function impairment.Different parts leukoencephalopathy can induce different influence on cognitive function.The cognitive function impairment caused by leukoencephalopathy correlates with the impairment of cholinergic pathways,with main effects of visuospatial/execution function,and the severity correlates with the impairment of cholinergic pathways. Key words: Brain infarction; Leukoencephalopathy; Cognitive function; Cholinergic pathways hyperintensities scale