Clinic Research On Cognitive Function And Event-related Potential In Patients With Non-disabling Ischemic Cerebrovascular Events (NICE) And The Relationship Between Blood Glucose Fluctuations

Objective: The study found that the Non-disabling ischemic cerebrovascular events(NICE)patients have different degree of cognitive dysfunction.This article aimed to investigate the cognitive function in patients with NICE damage characteristics and under the Go/Nogo paradigm Nogo-N2,P3 variation characteristics.At the same time,research of cognitive function in patients with blood glucose fluctuations and NICE,Nogo-N2,P3 correlation.For early identification of cognitive function in patients with NICE damage to provide an objective electrophysiological basis.Methods: Select 60 cases of the NICE patients hospitalized in the hospital of Neurology department during January 2017 to August as the case group(NICE group).According to the blood glucose fluctuations in three days after admission can be divided into two groups,the days large amplitude of glycemic excursion(LAGE)?4.4mmol/L group(group H)and the days LAGE<4.4mmol/L group(group L).At the same time to choice 30 patients hospitalized as the control group(NC group),which the gender,age,education level matched with NICE group.Using the simple intelligent Montreal cognitive assessment scale(MoCA)and mental state examination(MMSE)to assess the overall cognitive function.Using the clock Draw test(CDT),Stroop,2-back experiment test to assess the execution function.At the same time record the Nogo-N2,P3 characteristics in the Go/Nogo task of event related potentials(ERPs).And to Pearson correlation analysis between Nogo-N2,P3 and the CDT,Stroop and 2-back experiment.Result: 1.The NICE group compared with NC group:(1)The overall cognitive function assessment:(1)MMSE,MoCA scores comparison: The NICE groupMMSE,MoCA scores had lower than NC group,with statistical difference(P<0.01).(2)MoCA each score: The NICE group in the execution,memory,attention,named,abstract cognitive domain score decreased,with statistical difference(P<0.05),but the orientation and language score were no significant difference(P>0.05).(2)Computer aided neuropsychological tests:(1)CDT:Compared with the NC group the CDT score was reduced in NICE group,with statistical difference(P<0.01).(2)Stroop: Under the conflict condition the NICE group reaction time significantly prolonged(P<0.01),omission rate increased(P<0.01)and error rate increased(P<0.01).(3)2-back: The NICE group 2-back experiment error rate more increased than the NC group,with statistical difference(P<0.01).(3)The Go/Nogo task of ERPs:(1)Go task: The NICE group Go-P3 latency prolonged(P<0.01),amplitude decrease(P<0.01),with statistical difference;Go-N2 latency and amplitude were no significant difference(P>0.05).(2)Nogo task: The NICE group Nogo-N2,P3 latency were prolonged(P<0.01),Nogo-N2,P3 amplitude were lower(P<0.01),with statistical difference(P<0.01).(4)The Pearson correlation analysis: The Nogo-N2,P3 was correlated with the CDT,Stroop and 2-back experiment(P<0.01).2.H and L group comparison:(1)The overall cognitive function assessment:(1)The MMSE,MoCA score comparison: The H group Mo CA scale score was lower than L group(P<0.01),MMSE scale total score was no obvious difference(P>0.05).(2)MoCA each score: The H group execution,attention,memory cognitive domain scores decreased,with statistical difference(P<0.05),but language,naming,abstract and orientation fields were no significant difference(P>0.05).(2)Computer aided neuropsychological tests:(1)CDT: There was no obvious difference between L and H group in CDTscore(P>0.05).(2)Stroop: Uuder the conflict condition the H group omission rate significantly increased(P<0.01)and error rate increased(P<0.01),reaction time prolonged(P<0.05).(3)2-back: The H group 2-back experiment error rate more increased than the L group,with statistical difference(P<0.01).(3)The Go/Nogo task of ERPs:(1)Go task: Which in the H group,the Go-N2 amplitude and latency period were no obvious difference(P>0.05),the Go-P3 amplitude and latency period were no obvious difference(P>0.05).(2)Nogo task: Nogo-N2,P3 latency prolonged and amplitude reduced in H group,with statistical difference(P<0.05).(4)The Pearson correlation analysis: The Nogo-N2,P3 was correlated with the Stroop and 2-back experiment(P<0.01).Conclusion: 1.The NICE patients had cognitive dysfunction in the early,including visual space and execution,attention,memory,abstraction damaged.2.The NICE patients executive functions such as response inhibition and working memory refresh damaged significantly.3.Blood glucose fluctuations can aggravate the NICE cognitive function damage.4.The NICE patients Nogo-N2,P3 latency prolonged and amplitude reduced.At the same time had good correlated with the Stroop and 2-back experiment.Nogo-N2,P3 can be used for electrophysiological indicator detection of executive functionin NICE patients.