Study On The Relationship Between Lacunar Infarction And Sleep Rhythm And Emotional State

Objectives To investigate the relationship between cognitive and neurological dysfunction and sleep rhythm and emotional state in patients with lacunar infarction(LI),and to provide objective basis for early evaluation,management and rehabilitation of patients.Methods A total of 198 LI patients,aged 66.28±9.02 years,including 122 males and 76 females,were selected from the department of Neurology,Kailuan General Hospital affiliated to North China University of Science and Technology from January to June 2021.General patient data collection: age,gender,education level,body mass index(BMI)and with or without smoking history,drinking history,history of hypertension,diabetes,hyperlipidemia,high homocysteine levels hyperhomocysteinemia(HHcy)history,H history of high blood pressure.Cerebral magnetic resonance imaging(MRI)was used to record the distribution of infarcts.The AHI value was measured by sleep monitor within24～72 hours of admission,and the grade of obstructive sleep apnea-Hypopnea syndrome(OSAHS)was evaluated.Cognitive function and circadian type were assessed by minimental state examination(MMSE),circadian type inventory(CTI)assessed the ability to change one’s sleep rhythm,Zung’s self-rating depression scale(SDS)assessed depression,and Zung’s self-rating anxiety scale(SAS)for anxiety and the national institutes of health stroke scale(NIHSS)for neurological impairment.1 According to MMSE score,all patients were divided into the group without cognitive dysfunction(MMSE score 27～30points,n=204)and the group with cognitive dysfunction(MMSE score <27 points,n=180).2 According to NIHSS score,all patients were divided into the group without neurological dysfunction(NIHSS score 0,n=169)and the group with neurological dysfunction(NIHSS score >1,n=215).3 According to the AHI value,all patients were divided into normal and mild OSAHS groups(AHI value<15,n=109)and moderate and severe OSAHS groups(AHI value≥15,n=275).SPSS 23.0 software was used for data processing.Results In the cognitive impairment group,there were 139 cases of mild cognitive impairment(77.22%)and 41 cases of moderate cognitive impairment(22.78%),and the incidence of decreased attention,calculation ability and recall ability in MMSE was high.Cognitive dysfunction in the group with a history of drinking,HHcy history,H history of high blood pressure and the frontal lobe,temporal lobe,parietal lobe,thalamus,pons,and basal ganglia infarctions percentage,AHI value,OSAHS degree,SDS score,depression degree,weight loss,constipation of SDS scale scores and appear cases percentage were higher than no cognitive function.The percentage of CTI-Flexibility or rigidity scores and the number of cases of dizziness in SAS scale were significantly lower than those in noncognitive impairment group(all P<0.05).There was no significant difference in CTILanguid or vigorous score,SAS score and anxiety degree between two groups(all P>0.05).HHcy history,temporal lobe infarct foci,thalamic infarct foci,basal ganglia infarct foci,AHI value,CTI-FR score and SDS score were the influencing factors of cognitive dysfunction in LI patients(all P<0.05).2.In the neurological dysfunction group,there were 181 cases(84.19%)of mild stroke and 34 cases(15.81%)of moderate stroke.The percentage of patients with smoking history,drinking history,history of hypertension,history of HHcy,history of H-type hypertension,and presence of pons and basal ganglia infarction,AHI value,SDS score,the percentage of impaired ability and loss of interest items in SDS scale and the number of cases in the group with neurological dysfunction were higher than those in the group without neurological dysfunction.There were statistically significant differences(all P<0.05).The percentage of somatic pain and dizziness items and cases in SAS scale were lower than those in the group without neurological dysfunction,the differences were statistically significant(all P<0.05).There were no significant differences in OSAHS degree,CTI-FR score,CTI-LV score,depression degree,SAS score and anxiety degree between two groups(all P>0.05).History of hypertension,basal ganglia infarction and SDS score were the influencing factors of neurological dysfunction in LI patients(all P<0.05).3.The percentage of basal ganglia infarcts and NIHSS scores in moderate and severe OSAHS groups were higher than those in normal and mild OSAHS groups,while MMSE scores were lower than those in normal and mild OSAHS groups,with statistical significance(all P<0.05).There were no significant differences in the degree of cognitive and neurological dysfunction,CTI-FR score,CTI-LV score,SDS score,depression degree,SAS score and anxiety degree between two groups(all P>0.05).Conclusions 1.Poor sleep rhythm flexibility usually occurs when patients with lacunar cerebral infarction had cognitive dysfunction,and sleep rhythm changes were not obvious when patients with neurological dysfunction;Patients with lacunar cerebral infarction with cognitive dysfunction or neurological dysfunction were prone to depression.2.Patients with lacunar cerebral infarction accompanied by moderate to severe obstructive sleep apnea hypopnea syndrome were prone to cognitive dysfunction and neurological dysfunction,but had no significant impact on sleep rhythm and emotional state.3.Sleep biorhythm flexibility,SDS score,apnea hypopnea index,temporal lobe infarction,thalamic infarction,basal ganglia infarction,and history of hyperhomocysteinemia were the main influencing factors of cognitive dysfunction in patients with lacunar cerebral infarction.SDS score,basal ganglia infarction and history of hypertension were the main influencing factors of neurological dysfunction in patients with lacunar cerebral infarction.Figure0;Table27;Reference 68...