Cognitive Impairment And Relative Factors In Patients After Acute Ischemic Stroke

Background Stroke is one of the most common disease in old people, and even the second most common cause of death and adult disability around the world.important risk factor for the onset of strokes. With the improvement of the public health service and curing methods, the stroke mortality is falling down continuously, and more and more research has foucused on people’s function disabilities suffered from the stroke. It is universally acknowledged that stroke is associated with cognitive dysfunction and dementia, which seriously affected people’s life. However, it is likely to be ignored. Cognitive function is the important content of higher cortical brain, including memory, attention, calculation, time and spatial orientation, executive capacity, language comprehension and expression, application, and so on. Hence, cognitive function is of great significance to people’s life, study and work. With the development of chinese society, the stroke patients, especially the cerebral infarction patients have become more and more,also the patient who sufferred cognitive impairment after acute cerebral infarction. Therefore, the early detecting and the effective control of the relative factors of cognitive impairment after acute cerebral infarction, then improving cognitive function is critical. This study will make an investigation on the relative factors of cognitive impairment after acute cerebral infarction P s gioleExperiment 1 The relationship between the cognitive impairment and cerebral atherosclerosis after acute ischemic strokeObjective To investigate the association between the cognitive impairment and cerebral atherosclerosis after acute ischemic stroke. zzzMethods A total of 101 cases of acute ischemic stroke patients were recruited in this study. The Montreal Cognitive Assessment(Mo CA) was used to evaluate the degree of cognitive impairment. The American National Institutes of Health Stroke Scale(NIHSS) was used to evaluate the extent of neurological deficit. Magnetic Resonance Image(MRI) was used to evaluate the infaction locations. Color Doppler ultrasound, Magnetic Resonance angiography(MRA), Computerized Tomography angiography(CTA), Digital Substraction angiography(DSA) were used to assess the plaque characteristics and cerebral artery atherosclerosis. Results There was significant difference in the prevalence of cerebral atherosclerosis between the subjects with cognitive impairment and the control subjects(χ2 =18.137,P<0.001). Whereas, the degree of the atherosclerosis in the criminal vascular(p<0.001,r=-0365)was negatively correlated with the Mo CA rating(p < 0.05). Multivariate logistic regression analysis showed that cerebral atherosclerosis was an independent risk factor for the patient who have cognitive impairment after acute ischemic stroke(OR=1.702,95%CI0.982～2.952;P=0.048). Conclusions Cognitive impairment after acute ischemic stroke may be closely related to cerebral artery atherosclerosis and negatively correlated with the extent of the atherosclerosis in the criminal vascular and the most serious artery. Cerebral atherosclerosis was an independent risk factor for the patient who have cognitive impairment after acute ischemic stroke P s giole PfrExperiment 2 Relationship between Inflammatory Cytokines with Cognitive Impairment after Acute Lacunar Cerebral InfarctionObjective To investigate the relationship between inflammatory cytokines and cognitive impairment after acute cerebral infarction. Methods A total of 34 patients who have cognitive impairment after acute cerebral infarction were enrolled in the study. 30 patients who have normal cognitive function after zzzacute cerebral were recruited as the control. The blood samples were collected upon admission. Serum level of INF-γ was detected by enzyme-linked immunosorbent assay(ELISA), while that of IL-6 and TNF-α by chemiluminescence immunoassay. The Mini Mental State Exam(MMSE) was used to evaluate the degree of cognitive function. Results Compared with normal cognitive function group, the cognitive impairment patients after acute cerebral infarction had significantlty higher IL-6(t=2.668, P=0.010) and TNF-α(t=2.498, P=0.016) concentration,and the results remain significant after logistic analysis, but no statistical difference was observed in the level of INF-γ. Whereas, the serum levels of IL-6(r=-0.199, P=0.035)and TNF-α(r=-0.182, P=0.049)were negatively correlated with the MMSE scores. Conclusion Both of the serum levels of IL-6 and TNF-α are increased in the patients of cognitive impairment after acute cerebral infarction. In a certain degree, the levels of inflammatory cytokines may reflect early cognitive impairment after acute ischemic stroke. Experiment 3 Relative telomere length and cognitive impairment in patients after acute ischemic stroke in a hospital-based cohort in Chinese. gioleObjective To determine if peripheral blood telomere length is associated with cognitive impairment after acute ischemic stroke. Methods We tested the hypothesis that leukocyte telomere length correlates with cognitive impairment in a hospital-based cohort of 30 old adults(60-69years), who suffered the acute ischemic stroke within 24 hours in the hometown of Confucius. Telomere length was measured in blood leukocytes by quantitative polymerase chain reaction(PCR) and classified by mean as “short”, or “long”. Cognitive performance was estimated using Changsha version of the Montreal Cognitive Assessment(Mo CA). Results Our results demonstrated that there was a significant association between telomere length and cognitive function(P=0.016), especially in the executive function(P=0.008) and attention(P=0.010) areas. Further analysis found that the telomere length was positively correlated with cognitive performance(P=0.038). The association remains significant after P smultiple linear regression(P=0.035). Conclusions The study gives a support that the telomere length is associated with cognitive function and implies that it may be a biomarker for early detecting of cognitive impairment after acute ischemic stroke.