The Study On The Association Of Cognitive Impairment In White Matter Lesions With OSAHA And Serum A β 1-40

[Objective] Detecting the patients with cerebral white matter lesions by polysomnogram(PSG),their serum levels of β amyloid peptide 1-40(A β 1-40) volume, and evaluating cognitive function in patients through Montreal Cognitive assessment(MoCA) and Wechsler Memory Scale(WMS), to explore the relationship between OSAHS, Serum A β 1-40 and cognitive impairment in white matte* lesions.[Methods] All cases were form the department of Neurology, the Second Hospital of Kunming Medical University.70 cases of hospitalized patients from March,2015 to July,2015 were collected, and 35 cases with cerebral white matter lesions (WMLgroup),35 cases without cerebral white matter lesions (nonWML group).To Record general condition of the patients,including gender, age, height, weight, hypertension/diabetes/hyperlipemia history, smoking/drinking history and years of education, All selected patients were collected venous blood in the next morning, to determinate total A β 1-40 and serum triglyceride, cholesterol, low density lipoprotein and high density lipoproteins. All selected patients performed conventional cranial MRI (T1-weighted images, T2-weighted images and fluid-attenuated inversion recovery sequences and diffusion-weighted Imaging) as well as the polysomnography.All selected patients were required to carry out and complete the MoCA and the Wechsler Memory Scale to cognitive the function of cognitive and record the score. Using statistical software SPSS 20.0 compared two groups of areas of cognitive function score and the difference, and analyzed the correlation with A β 1-40.[Results] By cooperating and analyzing the general information on general aspects of WML group and the non-WML group as a whole, we found that age, the educational level,TC,TG,LDL-C,NONHDL,aPoBand UA had statistical differences(P<0.05),and the age, LDL-C, and NONHDL had significantly different(P<0.01); MoCA, Picture Recall, Visual Reproduction, Logical Memory and the Digit Span Test scores on experimental group are below the control group, and MoCA, Picture Recall, Visual Reproduction, Logical Memory scores had significantly different(P<0.01); MoCA, Picture Recall Visual Reproduction, Logical Memory scores in different degree of cerebral white matter lesions had significantly different(P<0.01); MoCA, Picture Recall, Visual Reproduction, Logical Memory and the Digit Span Test scores on OSAHS group are below the non-OSAHS group, and MoCA, Picture Recall, Visual Reproduction scores had significantly different(P<0.01);MoCA, Picture Recall, Visual Reproduction, Logical Memory and the Digit Span Test scores on WML subgroup with OSAHS are below the WMLsubgroup without OSAHS, and MoCA, Picture Recall scores had significantly different(P<0.01),Moreover,there is a positive association of AHI and severity of WML;Serum total A β 1-40 concentrations in WML group were significantly higher than those in the non-WML group, had statistical differences(P<0.01)and drive a positive correlation with severity of WML; Serum total A β 1-40 concentrations in OS ASH group were significantly higher than those in the non-OSAHS group and had statistical diflferences(P<0.01)and drive a positive correlation with AHI; Serum total A β 1-40 concentrations were negatively correlated with the cognitive test scores.[Conclusions] Our results suggest that OSAHS can aggravate damage of white matter lesions; and the association between the severity of white matter lesions and cognitive impairments is mediated by serum A β 1-40.OSAHS was a risk factor for white matter lesions.The cognitive tests of patients with white matter lesions showed cognitive impairments were positively correlated with severity of WML.