| Objective With the population aging, and the incidence of age-related diseases such as dementia increased year by year. Vascular dementia as the second largest common cause of dementia was gradually taken into account. The assessment of vascular cognitive dysfunction should involve every domains of cognitive function. The main neuropathological substrates which directly caused the cognitive impairment summarized are as follows:Multi-infarct encephalopathy, Infarcts in strategic areas, Lacunae and lacunar status, Binswanger’s encephalopathy, others: hippocampal sclerosis, watershed infarcts (infarcts in frontier areas). The cognitive characteristic of strategic regions infarction has been reserched in the previous studies. We aim to find the cognitive characteristic of non-strategic regions infarction, especially to the ones in the period of Vascular Cognitive Impairment Non-Dementia (VCIND). The results will have significant meanings for the diagnosis and differential diagnosis of vascular cognitive impairment.Methods Clinical and neuropsychological assessment information was collected during hospitalizing. The patients with acute ischemic stroke (42) in the Department of Neurology of our hospital and the health controls (20) receive comprehensive assessment between June.2012to December.2012. The assessment tools include Mini-Mental State Assessment Scale (Mini-Mental State Examination, MMSE), Rey hearing Chinese version of Verbal Learning Test to assess verbal memory function, Rey complex figure (Rey-Osterrieth Complex Figure) to assessment of their visual spatial memory function, the Stroop word-color interference test (Stroop Color-Word Test, SCWT), the connection tests A and B (Trail-making test A&B), Wechsler digit symbol test (symbol-digit test), semantic fluency test (semantic fluency) for his executive function. Semantic fluency test also can assess the patient’s language function. Acording to the Z score, the patients can be divided into2subgroups:VCI and VNC group.Results40patients have finished our assessment. The overall assessment of cognitive function, the MMSE score is lower in patients than the health controls. In the aspects of memory function, the patients have worse words delayed recall function and visual spatial memory function. But the instant words memory function and short term memory functions have no significant differences. In the aspect of executive function, the spirit of flexibility and the anti-interference ability are worse in patients. But the information processing speed and the capabilities of transductive reasoning have no significant difference. We also find that the memory function is associated with executive function. Among the post-stroke patients,15%of them ave visuospatial dysfunction,15%of them have visuospatial memory impairment; while20%experience verbal memory impairment,10%have instant verbal memory impairment,12.5%have short delay verbal memory impairment,20%have long delay verbal memory impairment;12.5%have language dysfunction;30%have executive dysfunction,12.5%have mental flexible abnormalities,10%have reasoning conversion disabilities,17.5%have speed of information processing abnormalities,7.5%had abnormal anti-interference ability.Conclusion Excluding the patients with strategic infarction, we find that among the non-strategic ischemic stroke patient with large artery atherosclerosis, there are47.5%of them have cognitive dysfunction. The rate of incidents of Executive dysfunction, visual spatial dysfunctions, memory dysfunction and language dysfunction fluctuates between10to30%, while the executive dysfunction is the most prominent. Memory dysfunction is dominantly manifested by the long term verbal delay dysfunction. The result suggests that these patients have imformation retrival dysfunction with the function of imformation storage preserved. The characteristic of cognitive impairment is helpful for us to decide whether the patient with VCIND is accompanied with AD. |
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