The Study Of Correlation Between Cerebral Microbleeds And Vascular Cognitive Impairment

Objective:Cerebral microbleeds(CMBs)is a subclinical brain parenchymal lesion characterized by red blood cell leakage and hemosiderin deposits caused by microvascular(40-200 μm)lesions in the brain.According to existing research findings,CMBs may be closely related to stroke,affective disorders,cognitive decline and increased risk of dementia.However,the results of studies on the impact of the location and number of CMBs on cognitive function are not uniform.Therefore,this study will discover CMBs through Susceptibility weighted imaging(SWI)and explore the relationship between the number,location and cognitive function of CMBs,and provide a certain theoretical reference for the early diagnosis and treatment of vascular cognitive impairment.Methods: 200 patients with Cerebral small vessel disease(CSVD)were selected from March2018 to December 2019 in the Department of Neurology,Affiliated Hospital of Yan’an University.Collect some demographic data and clinical data of 200 patients,perform SWI examination and MMSE,MoCA,Hachinski and other scale scores,divide patients into CMBs group and non-CMBs group according to the existence of CMBs,and record each case in CMBs group The number of CMBs and the location of CMBs,and then according to the number of CMBs,the patients were divided into CMBs0 group(N=0),CMBs1 group(N<5),CMBs2 group(5≤N<10)and CMBs3 group(N≥10)Analyze the difference in cognitive function among the four groups of patients,and analyze the correlation between the location of CMBs and each cognitive domain.Results: 1.General information of the research object: A total of 200 patients with cerebrovascular disease were included in this study,including 130 males(65.0%)and 70 females(35.0%),aged 42-80 years,with an average age of 63.44 ± 8.279 years old,88 cases with normal cognition(44.0%),112 cases with cognitive impairment(56.0%).There were 104 cases(52.0%)of CMBs and 96 cases(48.0%)of non-CMBs.The incidence of CMBs was 52.0%.2.Distribution characteristics of the number and location of CMBs: 848 microbleeds were detected in CMBs group,19 cases(18.3%)in cmbs1 group,49 cases(47.1%)in CMBs2 group and 36 cases(34.6%)in CMBs3 group.In CMBs group,the distribution of 848 microbleeds was as follows: 173 in frontal lobe,accounting for 20.4%;201 in temporal lobe,accounting for 23.7%;49 in parietal lobe,accounting for 5.8%;24 in occipital lobe,accounting for 2.8%;39 in cerebellum,accounting for 4.6%;72 in brainstem,accounting for 8.5%;116 in thalamus,accounting for 13.7%;174 in basal ganglia,accounting for 20.5%.From the above results,it can be found that the number of lobar microbleeds is the most,447 in total,accounting for 52.7%;the number of deep microbleeds is 290,accounting for34.2%;while the number of subthalal microbleeds is the least,111 in total,accounting for 13.1%.3.The correlation between CMBs and cognitive function: after the analysis of the total score of MOCA and the scores of each cognitive domain in CMBs group and non CMBs group,it was found that the scores of MOCA,visual space and executive function,attention,language,abstract thinking,delayed recall and orientation in CMBs group were lower than those in non CMBs group,and the differences were statistically significant(P≤0.001).4.Analysis of cognitive function among patients with different grades of CMBs: The total score of MOCA among patients with different grades of CMBs is significantly different,and the difference is statistically significant(F=106.86,P=0.000<0.001),Executive function,naming,attention,language,abstract thinking,delayed recall,and orientation also have obvious differences,and the differences are statistically significant(F=62.34、6.956、93.25、46.04、14.08、64.29、5.87,P≤0.001).After analyzing the chi-square method at all levels,it was found that the CMBs3 and CMBs2 groups had lower scores than the CMBs1 and CMBs0 groups in terms of visual space executive function,attention,language,and delayed recall,academic significance(P<0.008),while the CMBs3 group had lower scores in visual space executive function and attention than the CMBs2 group,and the difference was statistically significant(P<0.008).5.Correlation between the number of CMBs and cognitive function: After Spearman rank correlation analysis,it was found that the number of CMBs was negatively correlated with the total score of MOCA(r=-0.740,P=0.000<0.001);the number of CMBs was related to visual space executive function and attention,Language,delayed recall and orientation are also negatively correlated(r=-0.655、-0.712、-0.602、-0.634,P≤0.001).6.Correlation between CMBS and cognitive function: Pearson correlation analysis showed that there was a significant negative correlation between frontal CMBs and visual spatial executivefunction,attention,language and delayed recall(r=-0.894、-0.712、-0.628、-0.672,P=0.000<0.001);temporal CMBsand visual spatial executive function,attention and delayed recall(r=-0.606、-0.621、-0.856,P=0.000<0.001);CMBs in thalamus were negatively correlated with attention and delayed recall(r=-0.582 、-0.562,P=0.00<0.05);CMBs in basal ganglia were negatively correlated with attention,visual spatial executive function,language and delayed recal(r=-0.687、-0.571、-0.545、-0.578,P≤0.001);CMBS in all parts were not significantly correlated with naming,abstraction and orientation.Conclusions: 1.CMBs are related to cognitive impairment,which can damage visual space,executive function,attention,language,abstraction,memory and orientation.2.When the number of CMBs is equal to or greater than 5,cognitive function will be damaged.In terms of visual space,executive function and attention,the higher the number of CMBs,the more serious the function damage will be.In terms of language,abstraction and delayed recall,once the damage is caused,it will be the final result.3.The comprehensive evaluation of the number and location of CMBs is of great significance for the diagnosis of cognitive impairment and related cognitive domain damage.CMBs in frontal lobe,temporal lobe and thalamus can cause damage to visual space,executive function,attention and delayed recall.CMBs in basal ganglia can cause damage to both cognitive domain and language function.