Difference And Imaging Changes Of Vascular Cognitive Impairment Not Dementia In Patients With Acute Cerebral Infarction In Diabetes And Non Diabetes

Objective: Through registering the basic information of patients with acute cerebral infarction and vascular cognitive impairment not dementia(VCIND),the different factors between diabetes mellitus type 2(T2DM)and non T2 DM of all the participants were analyzed,and then the differences of cognitive function and imaging changes of VCIND in patients with acute cerebral infarction of T2 DM and non T2 DM were studied.Method:1.We have collected patients from the Department of Neurology at the Second Affiliated Hospital of Dalian Medical University through February to December in 2015,and there were 200 cases who had been diagnosed with acute cerebral infarction for the first time(within 2 weeks of onset),excluding the patient with infratentorial infarction and that combining cortical and subcortical infarction in the brain MRI(Magnetic Resonance Imaging).According to depression diagnostic criteria in ICD-10 F32,we excluded the patients with post stroke depression(PSD).Using the diagnostic criteria in HIS(Hachinski ischemic scale),CDR(Clinical dementia rating)scale and DSM-IV(The diagnostic and statistical manual of mental disorders,fourth edition),the patients with Alzheimer? s disease(AD),Vascular dementia(VaD)and mixed dementia(MD)were excluded.Evaluating the patients with Montreal Cognitive Assessment(MoCA)Beijing version,and according to classification and diagnostic criteria of Guidelines for diagnosis and treatment of Vascular cognitive impairment formulated by dementia and cognitive impairment group of neurology branch of the Chinese medical association(2011 edition),we selected 112 patients.Collect the data on the general conditions,biochemical examinations,carotid duplex ultrasound and MRI of the patients.Based on the diagnostic criteria concerning the diabetes of American Diabetes Association(2012 edition),the patients were divided into two groups,which were T2 DM group(n=58)and not T2 DM group(n=54).Compare the differences of the natural factors,biological factors,imaging performance,total score of MoCA scale,and various parts of MoCA between the two groups.2.Compare T2 DM group and non T2 DM group,and then clarify whether the factors below were statistically different.(1)General conditions: gender,age,degree of education.(2)Biological factors: hypertension,carotid artery atherosclerosis,atrial fibrillation,hyperlipidemia.(3)Imaging characteristics: the number of infarction lesions(single or multiple),the location of infarction(left or right cerebral hemisphere,cortical infarction or subcortical infarction),leukoaraiosis(LA)and its severity.(4)Total score of MoCA scale,the various points of MoCA scale.Results:1.Compared with the non T2 DM group,there was high proportion of patients with carotid atherosclerosis,which was statistically different between the two groups(P=0.002,P<0.01).2.Compared with the non T2 DM group,the proportion of patients with multiple cerebral infarction in T2 DM group was higher,which was statistically different between the two groups(P=0.04,P < 0.05).The lesion of cerebral infarction was mainly subcortical in group T2DM(P=0.015,P<0.05).The proportion of patients with LA in T2 DM group was higher,which was statistically different between the two groups(P=0.041,P<0.05).Compared with the non T2 DM group,the total score of T2 DM in group MoCA was lower than that in non T2 DM group,which was statistically different between the two groups(P=0.047,P<0.05).Compared with the non T2 DM group,the score of executive test in T2 DM group was lower than non T2 DM group,which was statistically different between the two groups(P=0.025,P<0.05),the score of memory test in T2 DM group was lower than non T2 DM group,which was statistically different between the two groups(P=0.001,P<0.01),and the left items were not statistically different.Conclusion:1.Through the comparison between T2 DM group and non T2 DM group,the proportion of patients with carotid atherosclerosis in T2 DM group was higher.2.Compared with the non T2 DM group,the proportion of patients with multiple cerebral infarction in T2 DM group was higher,and the lesion of cerebral infarction was mainly subcortical in T2 DM group.The proportion of patients with LA in T2 DM group was higher.The patient in T2 DM group had more severe cognitive impairment,especially for executive and memory function.