Clinic Research On Executive Function And Event-related Potential Visual P300 In Patients With Non-disabling Ischemic Cerebrovascular Events

Objective:To analyze characteristics of executive dysfunction in patients with Non-disabling Ischemic Cerebrovascular Events(NICE),detect the event-related potential P300 and analysis the correlation of executive function and P300,in order to find an objective electrophysiological indicator for evaluation of executive function in patients with NICE.Methods: Select neurology inpatients diagnosed with NICE in Southwest Medical University Affiliated Hospital as case group.According to the results of image examination offered two standards: acute infarction lesions?2 and intracranial/extracranial artery atherosclerotic stenosis?50%,which indicated high risk of stroke recurrence.NICE patients reached one or more as high-risk NICE group(HR-NICE group),reach none as normal-risk NICE group(NR-NICE group),each group included 30 people.Another 30 normal controls matched with gender,age and education also from inpatients without cognitive impairment in the same term.All patients completed the following tests: 1.Evaluation of general cognitive function: MoCA and MMSE were included;2.Neuropsychological executive function test: the Clock drawing test Trail(CDT),the Trail Making Test(TMT),the Stroop Test and 2-back task were included;3.ERPs: event-related potentials visual P300 was recorded for comparison and some correlation analysis.Result:1.Overall cognitive assessments:(1)MMSE: only HR-NICE group got lower scores in MMSE compared with controls,and the difference was statistically significant(P <0.05),there was no other significant difference when compared between HR-NICE group and NR-NICE group,nor between NR-NICE group and control group(P >0.05).(2)MoCA: both case groups got lower scores compared with control group(P <0.05),HR-NICE group also got lower scores compared with NR-NICE group(P <0.05),all differences were statistically significant.(3)Items of MoCA assessments: compared with controls,HR-NICE group did worse in most subitems(visuospatial/executive,attention,linguistics,memory and abstract)(P <0.05),NR-NICE group did worse in visuospatial/executive,memory and abstract(P <0.05),the differences were statistically significant;compared with NR-NICE group,HR-NICE group did worse in every subitem,but got statistically significant differences lower scores only in visuospatial/executive function,attention,linguistics and memory function(P <0.05).2.Neuropsychology executive function assessment :(1)the Clock drawing test Trail(CDT):both case groups got lower scores than the control group(P <0.05),HR-NICE group have lower scores than NR-NICE group(P <0.05),the differences were statistically significant.(2)the Trail Making Test(TMT): Compared with the control group,two case groups all showed prolonged reaction time in both TMT-A and TMT-B(P <0.05),and increased TMT interference quantity(P <0.05),the differences were statistically significant,and when compared in the two case groups,HR-NICE group manifested prolonged TMT-B reaction time(P <0.05)and increased TMT interference quantity(P <0.05),but no differences in TMT-A reaction time(P >0.05);(3)Stroop test: reaction time prolonged(P <0.05),error rate increased(P <0.05)under conflict condition in NR-NICE group compared with the controls,whereas the omission rate have no distinct(P >0.05),HR-NICE group got prolonged reaction time(P <0.05),increased error rate and omission rate(P <0.05)compared with both NR-NICE group and the controls.(4)2-back task : the error rate of 2-back task increased significantly in both case groups compared with the control group,and also increased in HR-NICE group compared with NR-NICE group(P <0.05),the differences were statistically significant.3.visual P300:(1)latencies of P300 prolonged significantly in both case groups compared with control group(P <0.05),and also prolonged in HR-NICE group compared with NR-NICE group(P <0.05),(2)amplitudes of P300 all declined significantly in case groups compared with control group(P <0.05),and in HR-NICE group compared with NR-NICE group(P <0.05).4.The correlation analysis: TMT-A reaction time,TMT-B reaction time,TMT interference quantity,Stroop reaction time,Stroop error rate,Stroop omission rate and 2-back error rate all have positive correlation with the latency of visual P300,but negative correlation with the amplitude of visual P300.Conclusions:1,the NICE patients existed damages in general cognitive function,MoCA was more sensitive in detecting cognitive dysfunction occurred in NICE patients.2,the NICE patients had comprehensive damages in executive function(including task-switching,response inhibition and memory refreshing),and the impairments in HR-NICE patients were more obvious than NR-NICE patients.3,Visual P300 had good correlation with TMT test,Stroop test and 2-back task,may be a proper electrophysiological indicator for evaluation of executive function.