The Relationship Between Cognitive Impairment And Ischemic White Matter Lesions

Objectives：The first purpose was to explore the incidence and relative riskfactors of cognitive impairment which was due to ischemic cerebral white matterlesions （WML）.The second aim was to investigate the influence about cognitivefunction impairment of patients with cerebral WML at different extent and differentlocation.Methods：75patients with WML were selected from the outpatients andhospitalizations in First Affiliated Hospital of Henan University of Science andTechnology.30normal age-matched people compose control group.WML patients weredivided into normal cognition group and abnomal cognition group according tomontreal cognitive assessment（MoCA）.Demographic data and vascular risk factorsof every patient were collected and compared between the normal cognition group andabnomal cognition group to find the risk factors of cognition impairment aboutWML.According MRI T2weighted-image and FLAIR image,WML patients wereclassified into3subgroups（mild,moderate and severe）depending on the extent.Alsowere classified into2subgroups（periventricular lesions and deep white matterlesions）depending on the location.The different effects on cognitive impairmentabout WML were accepted in extents and positions through comparing thesesubgroups.Results： Within the75patients with WML,cognitive impairment casespresented in44（58.7％）.Hypertension（OR4.050,95%CI1.309~12.526）,diabetes（OR3.820,95%CI1.103~13.231）and age（OR1.133,95%CI1.023~1.255）weresignificantly associated with cognitive impairment through logistic regressionsanalysis.Being compared with control group,WML patients had lower scores in totalMoCA score,including visual spatial,executive function,language,memory andorientation(P<0.05).Moderate and severe subgroups had lower scores inattention,calculation and abstraction (P<0.05).Severe subgroup had significantly lower scores in naming (P<0.05).Both the periventricular WML and deep white matterlesions subgroups had lower scores in total MoCA score including visualspatial,executive function,attention,calculation,language,abstraction,memory andorientation compared with control group(P<0.05).The periventricular WML patientshad lower scores in total MoCA score including calculation,language,abstraction,memory and orientation and had higher scores in visual spatial,executive function andattention compared with deep white matter lesions group (P>0.05).Conclusions：1.Hypertension,diabetes and age were associated with cognitiveimpairment.2.Patients with WML could represent cognitive fuction impairmentrefering to many fields,especially in visual spatial,executive function,language,abstraction,memory and orientation.The severer WML the lager the cognitive fuctionimpairment fields were induced.3.Periventricular WML and deep WML could conduceto the decline of cognitive functions.There were different effects between them.