Study Of The Correlation Of Microembolus Monitoring Middle Cerebral Artery And Vascular Cognitive Impairment

Objective and Background:Vascular cognitive impairment(VCI) is a continuum ranging from mild cognitiveimpairment to dementia caused by cerebral vascular risk factors or cerebral vasculardiseases.Many research data have demonstrated that cerebral vascular risk factors andcerebral vascular diseases are the high risk factors of VCI.Howere,the pathogenesis isunclear.In recent years,some researchers report that the positive rate of microembolussignal(MES) of dementia patients is higher,it follows that MES may play a importantrole of the progress of VCI.Through consulting inland document literature,we havenot currently found the report about the relation of MES and VCI.Some reports frominternational reserch date show that There is a definite link between MES and VCI,howere,the pathogenesis is unclear.This study was about to find the correlationof microembolus signals(MES) monitoring middle cerebral artery(MCA) of patientssuffering from acute cerebral infarction and vascular cognitive impairment (VCI).Methods:Transcranial doppler(TCD) is the best means of monitoring MES. It has a comp-lete automated analysis software and can stores large amounts of spectrum datedur-ing monitoring period.In order to ensure the correctness of MES,it canautomatically analyse in the connection state and artificially analyse in the off-linestate. The MCA stenosis of66cases of acute cerebral infarction patients and30casesof healthy controls were estimated by transcranial Doppler（TCD）,and monitored thequantity of MES of MCA. All patients were roughly divided into fourgroups:extreme stenosis group(group A),severe stenosis group(group B) and mediumgroup(group C) according to the Systolic blood flow velocity,Meanwhile30normalpersons would be as control group(group D).Calculating for each group the positiverate of MES,their cognitive impairment was estimated by Montreal cognitiveassessment(MoCA) rating scale.Finally,all date were analyzed by chi-square test,andusing linear correlation analysis to investigate the dependability between the stenosisdegree of MCA and MES,as wel as the correlation between MES and MoCA scale. Results:1、Stenosis extent of MCA of66cases patients is more serious than moderatestenosis (including moderate stenosis),there are57cases of patients with VCI.MESpositive rate of patients suffrered acuted cerebral infarction is28.8%(19/66), and82microembolus are recorded；2、MES positive rate of group A is53.8%(7/13), group Bis31.2%(10/32) and group C is9.5%(2/21),however the control group(group D) werenot detected microemboli. the microemboli positive rate of group A compared withgroup B and group C is the highest,and the date there is statistically significant(P<0.05). There was a positive correlation between the stenosis extent of MCA andMES﹙r=0.969，p＜0.05);3、All patients`mean MoCA score showed that group A(13.46±5.01)compared with group B(19.47±2.84) and group C(25.05±1.47) andgroup D(27.07±0.87) is the lowest.(P＜0.05);4、The MoCA score of19patients withMES have showed that group A compared with group B and group C is thelowest,and the date there is statistically significant (P<0.05).There was a negativecorrelation between the MES and MoCA score (r=0.958, P<0.05);5、The mean MoCAscore of Frontal lobe infarction(17.73±5.51) compared with Temporal(18.00±4.22)and Parietal(21.15±4.75)and Basal ganglia(21.15±4.75) andcontrol(27.07±0.87) is the lowest.(P＜0.05).Conclusion:There is a positive correlation between the stenosis extent of MCA and MES,andthe more stenosis the MCA lumen is,the higher the MES positive rate is.There is a negative correlation between the MES and MoCA score,and the morethe microemboli quantity are,the lower the MoCA score is and the more serious theVCI is;The more stenosis the MCA lumen is, the more serious the VCI is;The extent of VCI is associated with the location of cerebral infarction.