Vascular Cognitive Impairment In Patients Research Articles

Severe carotid artery stenosis evaluated by ultrasound is associated with post stroke vascular cognitive impairment.

BackgroundAcute ischemic stroke has been recognized as one key cause of vascular cognitive impairment (VCI). The purpose of this study was to evaluate the correlation between carotid artery stenosis and post VCI in acute ischemic stroke patients.MethodsIn this study, B‐mode ultrasound was applied to measure the degree of carotid artery stenosis. After 1 year, the stroke patients’ cognitive function was assessed by the mini‐mental state examination (MMSE) score. The relationship between the VCI and degree of carotid artery stenosis was evaluated by multivariate regression analysis.Results VCI was observed in 136 (37.2%) of the 365 participants. High degree of carotid artery stenosis was significantly correlated with VCI (p < .01), and this correlation remained unchanged even adjustment for age, gender, education level, stroke features, and vascular risk factors.ConclusionsThese findings indicate that high‐grade stenosis of carotid artery is positively correlated with post stroke VCI in patients with acute ischemic stroke. The evaluation of 1 year post stroke cognitive function may be a potential tool for screening stroke patients at risk of VCI.

Computed tomography perfusion imaging may predict cognitive impairment in patients with first-time anterior circulation transient ischemic attack.

To determine whether computed tomography perfusion imaging (CTPI)-derived parameters are associated with vascular cognitive impairment (VCI) in patients with transient ischemic attack (TIA). Patients with first-time anterior circulation TIA (diagnosed within 24h of onset) and normal cognition, treated between August 2009 and August 2014 at the Department of Neurology of Chengdu Military General Hospital, China, were analyzed retrospectively. Patients underwent whole-brain CTPI within 1week of TIA to detect cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) in the ischemic region. Based on cognitive function assessment 4weeks after TIA, using the Montreal cognitive assessment (MoCA) and mini mental state examination, the patients were divided into control and VCI groups. CTPI parameters and other clinical data were compared between groups, and Spearman's correlation analysis used to identify associations between cognitive scores and CTPI parameters in the VCI group. 50 patients (25 per group; aged 55-72years) were included. Patient age, gender, smoking status, alcohol consumption, educational level, time from TIA onset to admission, time from TIA onset to CTPI, and prevalence of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation and hyperhomocysteinemia did not differ between groups. Both groups showed TTP and MTT prolongation, CBF reduction, but no change in CBV in the ischemic region; these changes were significantly larger in the VCI group (P<0.05). MTT correlated negatively with MoCA score (r=-0.51, P=0.009). CTPI could facilitate early diagnosis of VCI in patients with anterior circulation TIA.

Impact of cerebral white matter changes on functionality in older adults: An overview of the LADIS Study results and future directions.

The evidence on the clinical significance of cerebral white matter changes (WMC) has mounted over the past few decades. WMC are recognized as one of the neuroimaging features of cerebral small vessel disease, and are associated with various disturbances and a poor prognosis. The Leukoaraiosis and Disability (LADIS) Study has contributed substantially to this body of knowledge. LADIS is a European multicenter collaboration aimed at assessing the role of WMC as an independent predictor of the transition to disability in initially non-disabled patients aged 65-84 years. Besides the demonstration that severe WMC cause a more than double risk of transition from an autonomous to a dependent status after 3 years of follow-up, the LADIS Study has also provided evidence on the role of WMC in relation to the decline of cognitive and motor performances, depressive symptoms associated with aging and cerebrovascular diseases, the presence of urinary disturbances, and various neurological abnormalities. The possible role of other lesions (lacunar infarcts, cerebral atrophy, corpus callosum morphology) and microstructural abnormalities (diffusion-weighted imaging changes in normal appearing brain tissue and in WMC) has also been investigated. In the present article, we review the main results of the LADIS Study and offer some considerations for future developments in the field, paying attention to the potential use of WMC progression as a surrogate marker in intervention trials in cerebral small vessel diseases. We also discuss some therapeutic perspectives regarding the beneficial impact of physical activity on the risk of vascular cognitive impairment in patients with WMC.

Vascular Cognitive Impairment in Adult Patients with Moyamoya Disease

Moyamoya disease (MMD) in adult patients is commonly accompanied by vascular cognitive impairment (VCI). The mechanism behind is still unclear and has been related to its hemodynamic disturbances. Surgical revascularization seems to be the only efficacious way to maintain the cognitive outcome, while problems such as the selection of operation indications and timing, and the long-term efficacy still need to be solved. The purpose of this article is to review the related literatures in recent years and to summarize the results in our research on the mechanism and surgical intervention of VCI in patients with MMD.

Multiple tooth loss is associated with vascular cognitive impairment in subjects with acute ischemic stroke.

Emerging evidence shows that tooth loss is associated with cognitive impairment and dementia. Vascular cognitive impairment (VCI) is a common consequence of ischemic stroke. This study investigated the association of tooth loss with VCI in patients with acute stroke. A total of 161 subjects with acute ischemic stroke were recruited. Within 1wk after admission, fasting blood tests were undertaken and the number of teeth present was recorded. VCI was evaluated with the Montreal Cognitive Assessment (MoCA). The patients with loss of ≥8 teeth exhibited significantly lower MoCA values as compared to those with loss of ≤7 teeth (13.2±6.6 vs. 17.3±6.0, p<0.001). Multivariate logistic regression analysis showed that loss of ≥8 teeth (OR=3.1, 95% CI: 1.2-7.9, p=0.02) and stroke history (OR=3.8, 95% CI: 1.1-14.1, p=0.04) were significantly associated with VCI (MoCA score ≤20.0). Within the limitations of this study, the current findings provide the first evidence that multiple tooth loss is independently associated with VCI in patients with acute ischemic stroke.

Analysis of risk factors for vascular cognitive impairment in patients with cerebral infarction.

This study aimed to identify risk factors for vascular cognitive impairment (VCI) in cerebral infarction patients. Associations between VCI and age, gender, blood pressure, lipid levels, glycosylated hemoglobin, atrial fibrillation, tobacco smoking, alcohol consumption, homocysteine (Hcy), and High-Sensitivity C-Reactive Protein (HS-CRP) were evaluated in patients with cerebral infarction (n=300) using single factor analysis and multivariate logistic regression analysis. By single factor analysis, the age, glycosylated hemoglobin, atrial fibrillation, blood pressure, Hcy, HS-CRP, tobacco smoking, and alcohol consumption were significantly associated with VCI in these patients. By multivariate logistic regression analysis, the age, glycosylated hemoglobin, blood pressure, Hcy, and HS-CRP were revealed as independent risk factors. The age, glycosylated hemoglobin, blood pressure, Hcy, and HS-CRP can serve as predictive factors for VCI in patients with cerebral infarction.

A prospective study of vascular cognitive impairment in patients with stroke

A prospective study of vascular cognitive impairment in patients with stroke

Vascular cognitive impairment in patients with late-onset seizures after an ischemic stroke

Background Cognitive impairment and seizures are both common conditions in patients with cerebrovascular disease. Purpose The present study investigates whether the occurrence of late-onset seizures, following an ischemic stroke, contributes to vascular cognitive impairment. Patients and methods The mean Mini-Mental State Examination (MMSE) and the median modified Rankin (mR) scores were compared between 125 patients who developed late-onset seizures (66 with a single seizure and 59 with repeated seizures or epilepsy) following an ischemic stroke and 125 patients who did not during, at least, a 2-year follow-up. Results There were no differences in age, gender, etiology and degree of neurological impairment on admission for their stroke between the groups with and without seizures. Although the mean MMSE score was similar between both groups the median mR score was significantly higher in the seizure patients. Comparing the patients with a single seizure to the non-seizure ones showed the same results. On the other hand, comparison of the patients with epilepsy to the non-seizure group revealed, in addition to the higher median mR score, a significantly lower mean MMSE score in the former group. Conclusion Repeated seizures following an ischemic stroke promote vascular cognitive impairment.