Effect Of Stent Implantation On Cognitive Function And Living Ability In Patients With Symptomatic Intracranial And Extracranial Artery Stenosis

Objective: The study was designed to assess the status of cognitive impairment of patients with symptomatic severe intracranial and extracranial arterial stenosis,and to explore the effects of stent implantation on patients’ cognitive function and daily living ability,which could provide clinical evidence for the prevention and treatment of vascular cognitive impairment.Methods: A total of 165 patients with symptomatic severe intracranial and extracranial major artery stenosis was included prospectively at the Lanzhou University Second Hospital from May 2020 to September 2021,who underwent cerebral artery stent implantation.To collecte the baseline data,clinical data and scale evaluation data of patients,the cognitive function score（Mo CA scale,MMSE scale）and daily living ability score（ADL scale,IADL scale）were appled for the patients before and 3 months after operation.Then the baseline data of these patients were analyzed,which were divided into two groups on the basis of gender,age,basic diseases,responsible blood vessels and status of cognitive function.Besides,to compare the baseline data of patients,the patients were divided into normal cognitive function group,MCI group and dementia group according to their status of cognitive function.The impairment characteristics of cognitive function domains were analyzed in all patients.Furthermore,the correlation analysis was conducted to compare the difference between daily living ability and the cognitive function of all patients.The overall cognitive function score,cognitive function domain score and activity of daily living score were uesd for patients before and 3 months after stent implantation.Finally,to analyze the differences in the scores of overall cognitive function and activities of daily living,all the patients were assigned into groups based on the responsible vessels and status of cognitive function.Results: 1.The ratio between male and female was 4.3:1,105 patients were over60 years old（63.7%）and 101 patients were diagnosed with MCI（61.2%）.2.Compared with patients aged under 60,the scores of MMSE,Mo CA and ADL were lower in patients aged over 60（P < 0.001）;The scores of ADL and IADL in patients with normal cognition were higher than those in dementia group and MCI group,and the scores of ADL and IADL in MCI group were higher than those in dementia group（P < 0.001）.3.The average age of patients in the dementia group was the oldest,MCI group was the second,and the cognitive function group was the smallest（P < 0.001）.4.Among the 165 patients,157（95.2%）had impaired visual space and executive function,153（92.7%）had impaired memory function,143（86.7%）had impaired attention function,and 56（33.9%）had five cognitive domains at the same time.5.MMSE（rs = 0.929,P< 0.001）,Mo CA（rs = 0.931,P < 0.001）and attention function（rs = 0.841,P < 0.001）were significantly correlated with ADL scores;MMSE（rs = 0.871,P < 0.001）and Mo CA（rs = 0.873,P < 0.001）were highly associated with IADL score.6.The scores,including visual space and executive function,naming function,attention function,language function,abstract function,memory function and orientation function,of all patients 3 months after operation were higher than those before operation（P < 0.05）.7.The scores of MMSE,Mo CA,ADL and IADL in 165 patients 3 months after operation were higher than those before operation（P < 0.001）;The scores of MMSE,Mo CA,ADL in 3 months after operation were higher than those before operation in anterior circulation group,posterior circulation group,intracranial artery group and extracranial artery group（P < 0.001）;The scores of MMSE,Moca,ADL in patients with normal cognitive function,MCI group and dementia group 3 months after operation were higher than those before operation（P < 0.001）;The patients in the group of MCI had the most differences of scores according to MMSE,Mo CA,ADL（P < 0.05）.Conclusions:1.Most patients with symptomatic severe intracranial and extracranial arterial stenosis have various degrees of cognitive impairment.The older the patients are,the worse the cognitive function is,as well as the ability of daily living.2.Patients with symptomatic severe extracranial and extracranial arterial stenosis often lead to the damage of visual space and executive function,memory function and attention function,and many patients are complicated with damage in five cognitive domains.3.The overall cognitive function of patients is significantly related to the ability of daily living,and the severe the impairment of cognitive function often cause the the damage to the ability of daily living in patients.4.Stent implantation can improve the visual space,executive function,naming function,attention function,language function,abstract function,memory function and orientation function of patients with symptomatic severe extracranial and extracranial arterial stenosis.5.Stent implantation can improve the overall cognitive function and the ability of daily living of patients with symptomatic severe intracranial and extracranial arterial stenosis,among which,patients in MCI group have the best efficient.