Functional Transcranial Doppler Clinical Study Of Vascular Cognitive Impairment

Objective: Explore the cerebrovascular reserve and event-related blood flowchanges of vascular cognitive impairment (VCI) patients, for VCI early diagnosis andintervention.Methods: Collected108cases of ischemic stroke patients in our hospital’Neurological Medicine Memory Disorders Clinic and Neurological Medicine StrokeUnits during August2009to August2011，all patients ischemic stroke course weremore than half a year.27patients of Vascular dementia (VaD),36patients of Vascularcognitive dysfunction without dementia (VCIND), and45patients of normal cognitivefunction (NC). Transcranial doppler (TCD) tested the subjects’ Mean blood flowVelocity (MFV), Pulsatility Index(PI) of the bilateral middle cerebral artery (MCA).The breath holding index (BHI) was detected during breath holding by TCD, whichwas the percentage of increased in MCA blood flow velocity. Functional transcranialDoppler (fTCD) detected the event-related CBFV of all subjects, and calculated thepercent of changed blood flow velocity (pCBFV).Results:1. The average age of the VCIND and VaD was older than the NCgroup(P<0.05); The average education years of the VaD and VCIND was shorter thanthe NC group(P<0.05); The rate of the VaD complicated with hypertension, diabetesand history of ischemic stroke was higher than the VCIND and NC group(P<0.05).2. The VCIND and VaD group of multiple infarctions proportion was higher thanthe NC group(P<0.05); The VCIND and VaD group of bilateral cerebral hemispherecases was higher than the NC group(P<0.05); The VaD group lesions in the leftcerebral hemisphere proportion was more than VCIND and NC group(P<0.05).3. Three groups of MoCA score pairwise comparisons were significantly different(P<0.05).4. The MFV of the VCIND and VaD group was lower than the NC group(P<0.05), there was no difference between VCIND and VaD group(P>0.05); The BHI values ofthe VCIND and VaD group was significantly lower than the NC group(P<0.05), nodifference between the VCIND and VaD group(P>0.05); The PI values of the threegroups were no statistically significant differences(P>0.05).5. The event-related CBFV of MCA detected by fTCD: the NC and VCINDsubjects’ event-related CBFV were higher than baseline MFV(P<0.05); There was nosignificant difference of the event-related CBFV and baseline MFV in VaD(P>0.05).Comparison of left and right MFV: the NC subject left event-related CBFV was greaterthan the right side(P<0.05), the VaD subject left event-related CBFV was lower thanthe right (P<0.05), no obvious difference in the VCIND subject(P>0.05).6. The event-related pCBFV detected by fTCD: The VaD and VCIND subjects’event-related pCBFV were significant lower than the NC subject(P<0.05); the VaDgroup pCBFV also lower than the VCIND group(P<0.05). Comparison of left and rightpCBFV: the NC group left event-related pCBFV was greater than the right(P<0.05), theVaD group left event-related pCBFV was lower than the right(P<0.05), no obviousdifference in the VCIND group(P>0.05).7. The correlation analysis showed that the BHI, pCBFV was positively correlatedwith the MoCA score(P<0.05). The BHI and pCBFV also positively correlated(P<0.05).Conclusions:1.Vascular cognitive dysfunction patients breath holding indeximpaired;2.The lateralization of event-related blood flow in vascular cognitivedysfunction patients was damaged.