Study On The Relation Between Mild Cognitive Impairment And The Change Of Hippocampus Volume In Patients With Stroke Derived From Small Artery Occlusion

Objective:To investigate the relation and how well they are related between mild cognitive impairment (MCI) and the change of hippocampus volume after patients suffer small artery occlusion(SAO); to measure the hippocampus volume of SAO patients and assess the cognitive function to offer new clinical evidences for early recognition of V-MCI and VaD; to discuss the possible pathology of cognitive impairment.Methods:Sixty-five eligible SAO patients were chosen according to the NEW TOAST, and after experiencing general situation assessment, laboratory examination, and MOCA evaluation, all of them were divided into2groups, V-MCI group and NC group, based on the diagnostic criteria of vascular cognitive impairment proposed by experts. By means of Hassan’s cavity obstruction assessment, patients were scored and accordingly divided into three subgroups:mild SAO, moderate SAO and severe SAO. The routine craniocerebral MRI, T1weighted imaging, T2weighted imaging, FLAIR, DWI and scanning of hippocampus area were performed to all these subjects. The normal control group contained52healthy people without any nervous system organic diseases, liver-kidney diseases or some relative diseases that can cause cognitive impairment, who came to take physical examination and matched closely with the research group in age, sex and education background. They have no drinking or drug abusing history, with total MOCA scores no less than twenty-six. All the data was dealt with t test, x2test, rank sum test, multifarious linear regression analysis and logistic regression analysis to make clear the relation between surveyed indexes and the volume of hippocampus.Results:1. Among V-MCI group, NC group and control group, the total scores of MOCA, scores of visual space, ability to act, attention, concentration and delayed memory of these two groups are obviously different from each other (p<0.05), but differences in scores of abilities of naming, language, abstract thinking and orientating function suggested no statistical significance. This indicated that the cognitive impairment of SAO patients was reflected in various aspects, mainly in visual space, ability to act, attention, concentration and delayed memory. The left, right and total volumes of hippocampus in V-MCI group are smaller than the other two groups.2. The morbidity rate of V-MCI in the three SAO groups was respectively16.7%,25.0%and59.3%, mild SAO<moderate SAO<severe SAO (p<0.05), indicating that the more severe the SAO was, the easier the cognitive function was to get impaired. The left, right and total volumes of hippocampus in severe SAO group are smaller than the other two groups. SAO has negative correlation with the hippocampus volume, and the more severe the SAO is, the smaller the hippocampus becomes.3. The hippocampus volume had negative correlation with blood sugar in two hours after meal, SAO and age, and had positive correlation with the number of years of education and MOCA scores. Blood sugar in two hours after meal, SAO and age were risk factors causing hippocampus volume decrease(P<0.05), but the number of years of education and MOCA scores were the protective factors of hippocampus volume(P<0.05).Conclusions:1. SAO can worsen the cognitive impairment and has positive correlation with it.2. The influence of SAO to the cognitive impairment is reflected in many aspects, mainly in visual space, ability to act, attention, concentration and delayed memory.3. SAO has negative correlation with the hippocampus volume, and the more severe the SAO is, the smaller the hippocampus becomes.4. Blood sugar in two hours after meal and SAO were independent risk factors causing hippocampus volume decrease, and the number of years of education was the protective factors of hippocampus volume.