The Preliminary Application Of Volume Quantification And Features Of Related Cognitive Disorders Of Leukoaraiosis

Backgroud: Leukoaraiosis（LA）is a kind of cerebral white matter lesions foundin old people.It may cause cognitive dysfunction,abnormal gait,urinary incontinenceand other symptoms.The etiology of LA has not been clear completely,but a growingnumber of studies suggest that LA is one of the cerebral small vasculardisease.Cognitive disorders related to LA is considered to be a subtype of vascularcognitive impairment(VCI).The performances of cognitive impairment arevariable,and recognized neuropsychological examination is lack at present,which maylead to inconsistent results.So the National Institute of Neurological Disorders andStroke-Canadian(NINDS-CSN) screened for a series of method of60minutesneuropsychological examination,which is designed for VCI research specially,but thatneuropsychological examination has been not used in the VCI research in China atpresent.In addition,visual qualitative evaluation was widely used to evaluate thedegree of LA in China,the research reported relations of LA volume and cognitivefunction was rare.Objective:Use the60minutes neuropsychological examination whichrecommended by NINDS-CSN to research the neuropsychological characteristics ofpatients with LA, and analyze the correlation between LA volume quantification andqualitative evaluation.Method: United States National Institute of Neurological Disorders Stroke andCanadian Stroke Network recommended60minutes neuropsychological tests, included memory function, attention ability, executive function, linguistic functionand visual spatial ability, was carried out on60LA patients (divided into mild,moderate and severe groups, according to Fazekas Standard)and29healthy controlsubjects. Use Image-pro Plus(IPP) to estimate the volume of LA and analyse thecorrelation between LA volume quantification and Fazekas qualitative evaluation.Results:1、Compared with the control group,in the mild LA group,difference of scoreson trail making test B(TMTB), trail making test A(TMTA),errors of Stroop colorword test C(SCWTC), symbol digit modalities test(SDMT),15seconds animals ofverbal fluency test(VFT), is statistically significant; in the moderate LAgroup,difference of scores on immediate recall,short recall,delayed recall andrecognition of the auditory verbal learning test(AVLT),Mini-Mental stateexamintion(MMSE),TMTB,errors of SCWTC,TMTA,SDMT,15seconds animals,45seconds,1minute of VFT,is statistically significant;in severe LA group,in addition tocomplex figure test(CFT), difference of other scores is statistically significant.2、In addition to recognition of AVLT，TMTB and errors of SCWTC,differenceof scores between Mild and moderate group is statistically significant; In addition toSCWTC errors,difference of scores between severe and mild group is statisticallysignificant;In addition to TMTB,difference of scores between severe and moderategroup is not statistically significant.3、The spearman correlation coefficient of Fazekas evaluation and LA volumeis0.828.4、 The spearman correlation coefficient of LA volume and MMSE,immediaterecall,short recall,delayed recall and recognition of AVLT,CDT,45seconds,1minuteof VFT was negative(r=-0.445～-0.258),statistically significant.the spearmancorrelation coefficient of LA volume and TMTB,time consuming of SCWTC waspositive(r=0.523,r=0.564),statistically significant.Conclusion:1.Executive function and attention ability damaged in mild LA patients,linguisticfunction,memory function,executive function and attention ability are damaged in moderate patients, visual spatial ability keeps complete in LA patient.In moderateperiod of LA,there is a significnt deteriorate in attention ability and executive function;In severe period of LA,there is a significnt deteriorate in executive function, butlinguistic function,memory function and attention ability progressed smoothly.2.The Image-pro Plus can be used to calculate the volume of LA.The generalcognitive function,memory function and executive function worsen with the growthof LA volume.