Characteristics And Influencing Factors Of Ecological Executive Function In Patients With Cerebral Small Vessel Disease Subtypes Of White Matter Lesions And Lacunar Infarction

Objective: At present,there are many researches on the executive function of cerebral small vessel disease at domestic and foreign,but there is no research report on the "ecology" executive function of cerebral small vessel disease.This study is to explore(1)to understand whether there are ecological executive dysfunction in patients with cerebral small vessel disease subtypes of white matter lesions and lacunar infarction;(2)cerebral white matter lesions and lacunarity in cerebral small vessel disease subtypes Factors influencing the ecological executive function of patients with cerebral infarction.Methods: 98 patients who were received in local hospital and diagnosed with cerebral small vessel disease subtypes of white matter lesions and lacunar infarction according to Brain Magnetic Resonance Imaging(MRI)from June 2016 to December 2017 were chosen as cerebral small vessel disease group.In addition,95 patients with normal MRI in the physical examination of local hospital during the same period were selected as the control group.Both groups were evaluated by the Behavior Rating Inventory of Executive Function-Adult Scale(BRIEF-A).White matter lesions were classified into mild,moderate,and severe groups according to the degree of disease.The lacunar infarction was divided into less lesion group and multi-lesion group according to the number of lesions.The differences in the ecological executive function of each group were compared and compared with the normal control group.Multiple linear regression analysis was used to investigate the correlation between the underlying factors of patients with cerebral small vessel disease and the score of the BRIEF-A scale.Results:(1)Total scores of BRIEF-A scale in cerebral small vessel disease group and its subtypes global executive composite(GEC),behavioral regulation index(BRI)and its inhibit,shift,emotional control,self-monitor factor,metacognition index(MI)and its initiate,working memory,plan,organization,and task monitor scores were higher than those of control group(P<0.05).(2)For patients with severe white matter lesions,their GEC,BRI,MI,initiate and working memory scores were higher than those of moderate and mild groups,while inhibit,shift,emotional control,self-monitor,task monitor and organization scores were higher than those of mild group.The difference was statistically significant(P<0.05).GEC,BRI,inhibit and organization scores in the moderate group were higher than those in the mild group,and the difference was statistically significant(P<0.05).(3)The scores of GEC,BRI,shift,emotional control,self-monitor and MI,initiate,working memory,plan,organization,and task monitor in the multi-lesion group were higher than those in the less lesion group,and the difference was statistically significant(P<0.05).(4)Multiple linear regression analysis showed that the severity of white matter lesions,the number of lacunar infarction lesions,age,hypertension,serum low-density lipoprotein level were positively correlated with BRIEF-A score(P<0.05),and education level was negatively correlated with BRIEF-A score(P<0.05).Conclusion: There are ecological executive dysfunction in patients with cerebral small vessel disease and its subtypes of white matter lesions and lacunar infarction.The ecological executive dysfunction is closely related to the severity of white matter lesions in patients,the number of lacunar infarction lesions,education level,age,hypertension,and serum low-density lipoprotein level.