Study On Resting Functional Magnetic Resonance Imaging(rs-MRI) Of Cognitive Impairment In Patients With Cerebral Small Vessel Disease

Objective:To evaluate the cognitive function of patients with small cerebral vascular disease(CSVD)and normal controls by using a series of cognitive function scales,and at the same time,carrying out resting state functional MRI(rs-f MRI)to explore the relationship between cognitive dysfunction and changes of brain function in CSVD patients,so as to provide certain imaging diagnosis basis for CSVD patients with cognitive dysfunction.Methods:In this study,we collected 29 CSVD patients hospitalized in the the Northern Jiangsu People’s Hospital from October 2017 to January 2019,and 25 normal controls with matching sex,age and years of education.We recorded the gender,age and years of education of the two groups,and the neurological function and cognitive psychology related scale scores,such as NIHSS,m RS,MMSE,Mo CA,MDRS-2,Stroop-C,AVLT,CFT,DST,CDT,v FT,semantic similarity test,were used to evaluate the neurological function of the subjects function,overall cognitive function and various fields of cognitive function.At the same time,subjects in the two groups were scanned by rs-f MRI,and the collected imaging data were analyzed as follows: 1.Use VBM to calculate the difference of gray matter volume between the two groups of subjects;2.Gray matter volume as covariate,the amplitude of low-frequency fluctuation(ALFF)values of each brain region of the two groups of subjects were calculated,and the correlation between brain region ALFF values and cognitive dysfunction impairment scores were analyzed.Results:1.General data: Totally 54 subjects were included,including 29 patients withCSVD,24 men(82.8%),average age(61.38±8.98),education years(9.31±2.82),17 with smoking history(58.6%),11 with drinking history(37.9%),10 with hypertension history(34.5%),14 with diabetes history(48.3%).In the NC group,there were 25 cases,20 males(80.0%),average age(64.80±3.43),education years(9.97±2.84),including 14cases(56.0%)with smoking history,6 cases(24.0%)with drinking history,10 cases(40.0%)with hypertension history and 10 cases(40.0%)with diabetes history.The results showed that there was no significant statistical difference between the two groups in gender(P=0.795),age distribution(P=0.065),years of education(P=0.403),smoking history(P=0.284),drinking history(P=0.272),hypertension(P=0.675),diabetes(P=0.225).2.Clinical neurological function and cognitive psychological evaluation: compared with CSVD group,NIHSS(P=0.000)and m RS(P=0.000)scores were statistically different in NC group,and the results showed that the neurological function of CSVD group was decreased;MMSE(P=0.007),Mo CA(P=0.000),MDRS-2(P=0.015)scores were statistically different,indicating that the overall cognitive function of CSVD group was decreased;Stroop-c(P=0.015),FT(P=0.000)and CDT(P=0.007)scores were statistically different,reflecting the decrease of execution ability and processing speed in CSVD group;there was statistical difference in CFT instant(P=0.010)and CFT recall(P=0.005)scores,indicating that the spatial conformation ability of CSVD group was decreased.The results showed that the neurologic function and the general cognitive level of CSVD group were decreased,and the cognitive impairment was mainly manifested in executive ability,attention,spatial conformation and so on.3.The gray matter volume of NC group and CSVD group was compared by two sample t-test(Alpha Sim correction,P<0.01,voxel size>71 was statistically different).The results showed that the gray matter volume of right basal ganglia(voxel size = 212)in CSVD group decreased.4.Gray matter volume as covariate,the ALFF value of rontal＿Mid＿Orb(left)(voxel size = 124),Frontal＿Mid＿Orb(right)(voxel size = 122),Frontal＿Mid(right)(voxel size = 87)and Frontal＿Sup＿Orb(left)(voxel size = 79),Supp＿Motor＿Area(left)(voxel size = 131),Supp＿Motor＿Area(right)(voxel size = 121)in CSVD group were reduced obviously.Conclusion:1.Cognitive impairment in CSVD patients is mainly manifested in executive ability,attention,spatial conformation,and memory impairment is relatively mild.2.The volume of gray matter in the right basal ganglia may be decreased in CSVD patients.3.In CSVD patients,ALFF value of BOLD mainly distributed in middle frontal gyrus,superior frontal gyrus and other brain regions.4.The decrease of executive ability,attention and spatial conformation in CSVD patients may be related to the decrease of CSVD in middle frontal gyrus and superior frontal gyrus.