SWI Study On The Correlation Between Cerebral Microbleeds And Cognitive Function In Elderly Hypertensive Patients

Objective: In this study,we used Susceptibility-weighted imaging(SWI)to study the relationship between hypertension and the severity of cerebral microbleeds(CMBs)and the correlation between the location,number and cognitive impairment of CMBs in elderly hypertensive patients,and to explore whether CMBs could be the imaging index of hypertension and cognitive impairment.Methods:Continuy to recruit 65 Elderly hypertensive patients through the network recruitment,the physical examination center and the Neurology department of the Second Hospital of Hebei Medical University from September 2018 to December 2018.Meanwhile,21 healthy elderly volunteers with normal blood pressure matched by age,sex,blood sugar,blood lipid and years of education were recruited as control group through physical examination center and network.General data,past history and test results of subjects were collected;And 3.0 T MRI routine sequences(T2WI,T2 FLAIR)and SWI sequence images were collected,Recording the distribution location and number of cerebral microbleeds in accordance with MARS scale;What’s more,total scores and each domains scores of MMSE and MoCA were evaluated.The incidence and distribution of CMBs and the correlation between the degree of hypertension and the severity of CMBs were studied by comparing the low-level,high-level hypertensive group and the control group.The effects of CMBs on general cognitive function and each domains,and the correlation between CMBs and cognitive impairment were studied by comparing the hypertensive CMBs positive and negative group,Meanwhile,the cognitive function differences of CMBs on three brain regions were also analyzed.Results:1.Altogether enrolled 65 elderly hypertensive patients,among the patients,the CMBs positive group was 26,accounting for 40%.The predilection region was Deep brain region(57.4%),in order,Basal Ganglia(Bg),Thalamus(Th),Deep and Paraventricular White Matter(DPWM)and External capsule(Ec);and the second was Lobar region(29.5%),in order,Temporal lobe,Parietal lobe,Frontal lobe and Occipital lobe;and the third was Infratenttorial region(13.1%),in order,Brainstem and Cerebellum.2.There were significant differences in Family History,White Matter Lesions(WMLs),Lacunar Infarction(LIs)among low-level,high-level hypertensive group and control group.3.The degree of hypertension was positively correlated with the number of CMBs(r = 0.445,P < 0.001);the number of CMBs was positively correlated with the degree of WMLs and the number of LIs(r = 0.346,P < 0.05;r = 0.299,P < 0.05).4.Systolic blood pressure is the risk factor for CMBs in the elderly hypertensive patients(P < 0.05).5.The percentage of cognitive impairment in elderly hypertensive CMBs positive group(34.6%)was significantly higher than that in negative group(5.1%)significantly(P<0.05).The total scores of MMSE in hypertensive CMBs positive group was slightly lower than that in negative group(P > 0.05);And hypertensive CMBs positive group were lower than negative group in the score of Attention,Calculation and Language ability significantly(P < 0.05).6.The Total Score of MoCA in hypertensive CMBs positive group was significantly lower than that in negative group(P < 0.001),and the score in Visual Space And Executive Function,Attention,Language and Delayed memory in hypertensive CMBs positive group were also lower than that in negative group significantly(P < 0.05).7.The severity of CMBs in elderly hypertensive group was negatively correlated with the total score of MoCA significantly.(r=-0.501;P<0.001)8.The score of Naming and Attention in Deep region alone of hypertensive CMBs group was lower than that in non-Deep region alone of hypertensive CMBs group significantly(P < 0.05);The total score of MoCA,Visual Space And Executive Function,Language in Deep region alone hypertensive CMBs group was also lower than non-deep region alone hypertensive CMBs group,but this was no statistical significance(P > 0.05);the total score and each domains of MoCA were no statistical significance,Comparing lobar alone hypertensive CMBs group with non-lobar alone hypertensive CMBs group(P > 0.05).Conclusions:1.The number of elderly hypertensive CMBs positive group was 26(40%).The degree of elderly hypertensive patients were positively correlated with the number of CMBs.2.The number of CMBs was positively correlated with the severity of WMLs and the number of LIs.3.Systolic blood pressure is the risk factor for CMBs in the elderly hypertensive patients,and the course of hypertension is not related to CMBs in the elderly hypertensive patients.4.CMBs could be used as the imaging index of hypertension and cognitive impairment in the elderly: The severity of CMBs is negatively correlated with the general cognitive function in elderly hypertensive patients;CMBs led to general cognitive impairment and the decrease of Visual Space And Executive Function,Attention,Language and Delayed Recall significantly.CMBs in the Deep brain region alone affected the Naming and Attention.