Clinical Research On Cognitive Impairment Of Cerebral Infarction Patients In Acute Stage

Background and Objective:Cerebral infarction can causes different degree cognitive impairment, which not only affect healthy and quality of life severely, also increase the burden on society and family. Its early diagnosis can provide best time for intervention, treatment and delay its progress. This article aimed to investigate cognitive impairment of cerebral infarction in acute stage and its characteristics, related risk factor, imaging features and application value of P300 and N400, providing experimental basis for its early diagnosis, prevention and cure.Methods:The cognitive function of 31 cases of cerebral infarction and 26 cases of normal control group were evaluated by mini-mental state examination (MMSE), clock drawing test (CDT), event-related potential P300 and N400. Cerebral infarction group was divided into 3 group according to MMSE:group A (MMSE≥27), group B (dementia boundary value of various cultural level≤MMSE<27), group C (MMSE< dementia boundary value of various cultural level), and collected their related clinical data for statistical analysis by SPSS 13.0 software.Results:1. In 31 cases of cerebral infarction in acute stage, there were 8 cases (group A) without obvious cognitive impairment,16 cases (group B) with cognitive impairment no dementia which has lower score in time orientation, calculation and attention, short-term memory and CDT than group A,7 cases (group C) with dementia which has lower score in language understanding and figure delineation than group A in addition to the above-mentioned areas.2. The patients with old age, low years of education, high blood pressure, heart disease, carotid artery intima-media thickening and plaque formation had lower MMSE score than normal control group, the difference was statistically significant (P<0.05), while gender, smoking, drinking, diabetes, hyperlipidemia and previous stroke had no significant effect on MMSE scores (P>0.05).3. The MMSE score in patients with leukoaraiosis were significantly lower than those without leukoaraiosis, and more severe leukoaraiosis, lower MMSE score.4. Compared with normal control group, P300 and N400 latencies were prolonged and amplitudes were reduced significantly in cerebral infarction group. Compared with normal control group and group A, there was a significant prolonged in P300 latency in group B, while there was no significant differences in P300 latency, N400 latency and amplitude among them. P300, N400 latencies in group C were obviously longer and amplitudes were obviously lower than those in normal control group and group A. P300, N400 latencies and amplitudes were significantly correlated with MMSE scores, N400 latencies were significantly correlated with language function.Conclusion:1. Cognitive impairment is a common complication of cerebral infarction. Cerebral infarction patients in acute stage had some degree cognitive impairment, which displays damage of time orientation, calculation and attention, short-term memory and executive functions in early, while general damage of time orientation, calculation and attention, short-term memory, executive functions, language comprehension and figure delineation in severe time.2. Combined MMSE and CDT can detect mild cognitive impairment earlier.3. Old age, low years of education, high blood pressure, heart disease, carotid artery intima-media thickening and plaque formation might be the main risk factors for cognitive impairment of cerebral infarction.4. Cognitive impairment of cerebral infarction patients with leukoaraiosis was more obvious than those without leukoaraiosis, and its extent of the damage was related with the severity of leukoaraiosis, more severe leukoaraiosis, more obvious cognitive impairment.5. There is an important value in P300 for evaluation of cognitive impairment of cerebral infarction in acute stage, particularly that, the prolong of P300 latency might be a sensitive index for early cognitive impairment. There was not only significantly longer P300 latency, but also significantly lower amplitude when cognitive impairment was severe.6. N400 can be used for evaluation of cognitive function of cerebral infarction in acute stage, particularly language function. N400 latency was significantly related to language function, longer latency suggests more obvious language function impairment.