The Value of Brain Structural Magnetic Resonance Imaging Combined with APOE--ε4 Genotype in Early Diagnosis and Disease Progression of Senile Vascular Cognitive Impairment No Dementia.

Weina Zhao,Siyao Che,Lili Cui,Fengbo Yu,Lifei Wan,Changhao Yin,Yuvaraja Teekaraman

doi:10.1155/2022/8613024

Abstract

Objective To explore the value of brain structure magnetic resonance imaging combined with APOE-ε4 genotype in the early diagnosis and disease progression of elderly patients with vascular cognitive impairment no dementia (VCIND). Methods The first stroke patients admitted to our hospital from March 2017 to December 2018 were collected, including 130 cases of vascular cognitive impairment no dementia (VCIND group) and 50 cases of the control group (NC group). The basic information of all subjects was recorded, and APOE-ε4 alleles of all subjects were detected. The neuropsychological test scale evaluated the cognitive psychology of the subjects, and they were scanned by multi-parameter MRI. After follow-up, VCIND patients were divided into the dementia group and the nondementia group. MRI scans were again performed, and the risk factors of VCIND patients developing dementia were analyzed. Results Compared with the NC group, patients in the VCIND group had shorter years of education, more patients with hypertension, higher levels of homocysteine (Hcy), and lower cognitive ability. Patients with White Matter Volume (WMV), White Matter Hyperintensity (WMH), Lacunar Infarction (LI), elevated Fazekas scores, and APOE-ε4 gene carriers are more likely to develop VCIND. After 12 months of follow-up, compared with the nondementia group, the number of WMV, WMH, Fazekas scores, and APOE-ε4 gene carriers in the dementia group was significantly increased. In addition, the progression-free survival rate of APOE-ε4 gene carriers was significantly lower than that of nonAPOE-ε4 gene carriers. Conclusion Years of education, hypertension, high levels of Hcy, elevated WMV, WMH, LI, and Fazekas scores, and carrying the APOE-ε4 gene are risk factors for VCIND in stroke patients. Craniocerebral structural MRI combined with APOE-ε4 genotype has a diagnostic role in the early diagnosis and disease progression of elderly patients with VCIND.

Highlights

Vascular cognitive impairment (VCI) is a syndrome ranging from mild cognitive impairment to dementia and is the second cause of Alzheimer’s disease in China [1]
According to whether cognitive dysfunction occurred, all patients were divided into the vascular cognitive impairment no dementia (VCIND) group (n 130) and the control group (NC group, n 50). e Hongqi Hospital Affiliated to Mudanjiang Medical University committee approved this study
Inclusion criteria: (1) all subjects aged 65–80 years old; (2) the interval between stroke onset and hospital visit is 3 to 12 months; (3) the duration of cognitive impairment is 3 months or more; (4) Clinical Dementia Rating (CDR) ≥ 0.5 and Activities of Daily Living Scale (ADL) score

Summary

Introduction

Vascular cognitive impairment (VCI) is a syndrome ranging from mild cognitive impairment to dementia and is the second cause of Alzheimer’s disease in China [1]. It is reversible in the early stage and is currently one of the preventable dementia diseases. VCIND is an early stage of mild cognitive impairment caused by cerebrovascular injury. Its degree of damage to cognitive function has not reached the criteria of dementia. Contrast Media & Molecular Imaging common damage sites are the cerebral subcortex and frontal lobe, but as the disease progresses, many VCINDs can develop into VD [3]. The therapeutic effect of drug intervention for VD is still not ideal. erefore, it is of great significance to actively carry out research and early prevention and treatment of VCIND, improve early symptoms, and delay the progression of the disease course for the prevention and treatment of VD

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Results

Conclusion