Correlation Of Serum VEGF With Cerebral White Matter Hyperintensity And Cognitive Impairment No Dementia In Patients With Cerebral Small Vessel Disease

BackgroundCognitive impairment caused by cerebral small vessel disease（CSVD）is the hotspot of current research.It is difficult to identify early in clinic because of pathogenesis unclear and hidden onset.Studies have shown that the combination of biological markers and imaging markers could predict cognitive decline accurately.Vascular endothelial growth factor（VEGF）is the main hypoxia-induced angiogenesis i-nitiator and is closely related to vascular endothelial function.Studies have shown that vascular endothelial dysfunction caused by hypoperfusion was not only the pat-hological basis of white matter hyperintensities（WMHs）in CSVD,but also the core pathogenesis of cognitive impairment caused by CSVD.Therefore,it is speculated that VEGF may be involved in pathological process of cognitive dysfunction and WMHs caused by CSVD.This study took the early stage of cognitive impairment-vascular cognitive impairment no dementia（VCIND）as the research content,and focused on the level of VEGF in patients with CSVD and its relationship with WMHs at VCIND,so as to provide reference basis for early identification and prevention of cognitive impairment in patients with CSVD.ObjectiveTo investigate the relationship between serum VEGF levels and white matter high signal and cognitive impairment no dementia in patients with CSVD.Methods106 patients with CSVD admitted to the Neurology of the first affiliated hospital of Xinxiang Medical University from April 2019 to December 2020 were enrolled.They were divided into vascular cognitive impairment no dementia group（VCI-ND group,n=47）and non-cognitive impairment group（N-VCI group,n=59）accord-ing to Minimental assessment scale（MMSE）,Montreal cognitive assessme-nt scale（Mo CA）and Activities of daily living scale（ADL）.Serum VEGF levels were measured with enzyme linked immunosorbent assay（ELISA）in all patients.The baseline data,serum VEGF levels,Mo CA score and Fazekas score were compared between the two groups.The correlation between serum VEGF level and white matter h-ypersignal and cognitive function was analyzed.Results1.A total of 106 patients with CSVD were included,The incidence of cognitive impairment no dementia in this study was 44.3%.2.There were significant differences in years of education,serum VEGF level,Mo CA score and Fazekas score between the two groups（P<0.05）.3.The level of VEGF（β=0.008,OR=1.008,95%CI=1.001～1.015,P<0.05）was influencing factor of cognitive function in patients with CSVD.4.The level of VEGF was negatively correlated with the total score of Mo CA,attention and calculation power,and orientation ability（r=-0.345,r=-0.373,r=-0.445,P<0.05）and it was positively correlated with the total score of Fazekas score and the Fazekas score of paraventricular and deep white matter（r=0.392,r=0.495,r=0.302,P < 0.05）.5.There was a linear trend between the high signal grade of paraventricular and deep white matter and VCIND（P < 0.05）.ConclusionSerum VEGF level was correlated with cognitive function and white matter hyperintensity in patients with CSVD.The increase of VEGF level may be a factor reflecting cognitive dysfunction.The proportion of CSVD patients with VCIND increases with the increase of white matter hypersignal grade.