The Investigation Of AD8and Cog12in Screeing Vascular Mild Cognitive Impairment And The~1H-MRS Features

Objective1.To investigate the application value of scales AD8and Cog12in screeing thevascular mild cognitive impairment(v-MCI), we tested the people with nomalcognition,patients with v-MCI and patients with vascular dementia(VD), with a battery ofneuropsychological scales.2. To investigate the proton magnetic resonance spectroscopy(1H-MRS) features ofpatients with v-MCI, we detected patients with v-MCI and patients with nomal cognitionby1H-MRS.MethodsPart one:We selected the people as objects, who visited the hospital of the PLA88forcerebrovascular disease(CVD) or risk factors for CVD from February2012to February2014. The objects were divided into normal control(NC) group,VD group and v-MCIgroup. All objects were tested with a wide battery of neuropsychological tests such as AD8and Cog12. We analyzed the scores of different groups and investigated the sensitivity andspecificity of some scales.Part two:We choosed patients who were older than50from the v-MCI group and NC group inpart one. Examed by MRI, the patients would be rejected if they had a large area ofcerebral infarction or key point infarction such as frontal lobe, thalamus and cornuammonis or diffuse leukodystrophy. Selecting both lobes of frontal lobe, temporal lobe,thalamus and cornu ammonis as region of interest(ROI), we examed the matched patientsby1H-MRS.With NAA/Cr and Cho/Cr as observation indexes, we calculated andcompared the value of NAA/Cr and Cho/Cr from different parts, investigated the value of MRS in detecting the v-MCI early.We divided the patients with v-MCI into twogroups:one group with high score of AD8,another group with normal score of AD8,compared the difference level of metabolin from the two groups.ResultsPart one:1. Three was no obviously difference in age, sex and education between patients withNC, v-MCI and VD(P>0.05).2. The ratio of hypertension and CVD in v-MCI group was higher than the NCgroup,and lower tthan the VD group (χ2test，P<0.05), the ratio of cardiac disease, diabetes,hyperlipemia, smoking,and drinking was not obviously different between them(χ2test，P>0.05).3. The scores of the MMSE and Moca in v-MCI group were higher than the VDgroup,lower than the NC group (P<0.01), the scores of AD8and Cog12were higher thanthe NC group, and lower than the VD group.4. In distinguishing the patients with v-MCI from patients with normal cognitition:(1) There was no obvious difference between MMSE and Moca,similar to AD8andCog12(P>0.05). The AD8and Cog12surpassed MMSE and Moca,with significantdifference.(2)When the cutoff value was26.5, MMSE was slightly lower than Moca(the cutoffvalue was23.5) in sensitivity and specificity,but they were equal in general. When thecutoff value was1.5, there was no difference between AD8and Cog12in sensitivity andspecificity,which were higher than MMSE and Moca.5. Moca、MMSE、AD8and Cog12had similar discrimination between v-MCI and VD,the difference was not statistical significant.5. With the comparision of the three groups in each cognitive domain, the scores ofthe scales in v-MCI group were all lower than the NC group (P<0.05), higher than the VDgroup(P<0.05), except the score of the scale group color-word test(part C),it was higherthan the NC group(P<0.05)lower than the VD group (P<0.05). The score of thedelayed-memory in v-MCI group and VD group was increaseed, compared with the scoreof the immediate memory(P<0.05).Part two:1.Compared with the normal control group,the ratios of NAA/Cr in v-MCI groupwere lower in both frontal lobes, temporal lobes, thalamuses and cornu ammonises, the difference was significant(P<0.05). The differences of Cho/Cr ratio in the both group werenot statistical significant(P>0.05).2.The ratios of NAA/Cr in the left lobe of the v-MCI group were lower than the right,with statistical significance(P<0.05),the differences of the Cho/Cr ratio in both sides werenot statistical significant(P>0.05).3.Compared with the group with v-MCI who got normal score of AD8,the NAA/Cr ofthe left was lower in the group with high score of AD8(P<0.001).There was no significantdifference between the two groups of the right side of NAA/Cr.ConclusionsPart one:Compared with Moca and MMSE, AD8and Cog12have better validity in screeningthe patients with v-MCI. In screening the patients with VD, all of them have better validity.AD8and Cog12can help detecting the v-MCI early.Part two:There are metabolic abnormalities in the patients with v-MCI,who are screened byAD8and Cog12,in both side of frontal lobe, temporal lobe, thalamus and cornuammonis,especially the left.Research SignificanceThe research detailed analyzed the value of AD8and Cog12in screening cognitivefunction of v-MCI and1H-MRS features in the patients with v-MCI,and confirmded that theAD8and Cog12scales have sensibility in screening the patients with v-MCI, it can provida new method for earlier screening accordingly.