| Objective:Cognitive impairments after ischemic stroke are often overlooked,particularly in patients with mild or transient deficits.We assessed patients with transient ischemic attack(TIA)and minor stroke with serial cognitive screening tests and neurophysiological examinations,we aim to assess early cognitive function in patients with TIA/minor stroke and to determine if changes in latencies and amplitudes of the major waves of EventRelated Potentials(ERPs-P300),correlate with cognitive impairment of TIA/minor stroke patients.Subject and Methods: We studied a series of consecutive 65 TIA/minor stroke patients(mean age is 50.67±9.54 years old,19 TIA patients,46 minor stroke patients).They were enrolled into our study from June 2015 to December 2016.All enrolled patients were planed to be evaluated by neuropsychological and neurophysiological tests on the 4th to 10 th day,all patients had completed evaluation.Information about neuropsychological tests and latencies and amplitudes of the major waves of ERP-P300 were collected.All the patients were divided into normal cognitive(NC)group and cognitive impairment group which include vascular cognitive impairment no dementia(VCIND)group and dementia(Va D)group.We aim to investigate the characteristics of the patients with vascular cognitive impairment no dementia(VCIND)in terms of neuropsychology.Among group differences in latency and amplitude of the major ERPs waves(P300 Wave)were determined.Within each group,correlation coefficients(CC)between these characteristics of the different P300 waves were calculated.Finally,for patients,CCs were determined among each P300 wave and Mo CA and excutive functions scores.Results: 1.Compaired with NC group,the scores of excutive/visuospatial function and delayed recall in VCIND are lower,the scores of excutive/visuospatial function in NC group are 4.47±0.51,VCIND group are 2.79±0.65,the scores of delay recall in NC group are 4.00±0.61,VCIND group are 2.31±0.81(P<0.05)2.In the healthy control group,the scores of the latency of P300-Fz are 318.78±13.22 ms,P300-Cz are 316.24±15.67 ms,P300-Pz are 320.56±19.32 ms.In the NC group,P300-Fz are 347.82±12.11 ms,P300-Cz are 350.64±9.79 ms,P300-Pz are 353.76±12.17 ms.In the VCIND group,P300-Fz are 368.90±17.81 ms,P300-Cz are 369.23±25.52 ms,P300-Pz are 372.79±15.01 ms.The P300 latency in the NC group and VCIND group are longer than the healthy control group(P<0.001).The difference of amplititude is not statistically significant.The P300 latency of each site in the VCIND group are longer than NC group(P<0.001)).3.Latency of P300-Fz are correlated with both Mo CA scores(r=-0.799,P<0.001)and scores of visuoexcutive and recall delay(r=-0.895,P<0.001),after adjusting for potential confounders,the regression equation between P300-Fz latency and the Mo CA scores/scores of visuoexcutive and is statistically significant(P<0.001).4.The sensitivity of the latency of P300-Fz is 0.875,the specificity is 0.765 when the latency of P300-Fz is 358.55 ms.Conclusions: 1.The cognitive impairment of VCIND after TIA or minor stroke is characterized by visuoexcutive and recall delay impairments.2.2.P300 can be used as an useful and objective tool in detecting cognitive impairment of patients with TIA/minor stroke.P300-Fz is more sensitive in screening cognitive dysfunction of TIA/minor stroke patients and it may indicates the visuoexcutive and recall delay impairments.Both the sensitivity and specificity of are good.Together with neuropsychological scale,P300 can be a useful and objective tool in the screen of cognitive dysfunction after TIA/minor stroke. |
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