The Capacity Of Cognitive Control In Patients With Cerebral Small Vessel Disease

BackgroundCerebral small vessel disease,which has arisen much attention around the world,is very common in middle-aged people and especially the old.Although a small number of the patients with CSVD were diagnosed after they got stroke,most of them are not easy to identify because the absence of typical motor symptoms.They may have clinical symptoms such as cognitive decline,gait disturbance,mood problems and sphincteric dysfunction,in which cognitive impairment is recognized as the most significant one by neurologists.CSVD has become an important cause of vascular cognitive impairment.Studies have found that CSVD is involved in most of the cognitive domains,particularly executive function and information processing speed.Executive function is supported by cognitive control which has its upper limit called cognitive control capacity.It seems like that there is no study focusing on CSVD’s cognitive control capacity before.ObjectiveTo figure out whether there is decline in CSVD’s cognitive control capacity or not.To investigate the relationship between CSVD’s cognitive control capacity and other neuropsychological tests.To assess the predict value of CCC on the occurrence of CSVD.MethodsThere are twenty-one patients with CSVD and twenty-two healthy people involved in this study.All of the participants complete the MFT-M and a set of neuropsychological tests.ResultsCCC of patients with CSVD was lower than that of healthy control [(2.97±0.72)bpsvs(3.53±0.62)bps,t=-2.704,P=0.01].Between patients with CSVD and healthy control,there were significant differences in Mo CA [(22.24±4.58)vs(24.86±2.42),t=2.334,P=0.026],VFT-animal [12(6)vs 15(6),Z=-2.965,P=0.003],VFT-vegetables and fruits [(13.79±3.81)vs(18.27±4.13),t =-3.592,P= 0.001],CAVLT-immediate [(7.45±2.18)vs(9.11±2.08),t=-2.502,P= 0.017],CAVLT-short term delay[(7.20±3.32)vs(10.76±3.08),t=-3.564,P= 0.001],CAVLT-long term delay [(7.30±3.16)vs(10.29±3.18),t=-3.012,P= 0.005],SDMT [(15.95±5.49)vs(23.41±12.73),t=-2.513,P= 0.018],CTT-A [85.17(42.60)vs 55.50(52.65),Z=-2.965,P= 0.003],CTT-B [(200.69±71.35)vs(132.44±53.66),t=3.556,P=0.001],and CTT-B-A [(104.13±53.31)vs(65.20±35.98),t= 2.819,P=0.007].There was no significant difference in VFT-word begin with Chinese character “water” [(3.68±2.63)vs(5.44±2.71),t=-1.940,P= 0.061],CAVLT-recognition [14(3)vs 14(4),Z=-0.524,P= 0.601],DS-forward [7(3)vs 5.5(2),Z=-0.152,P=0.880],DS-backward [4(1)vs 4(2),Z=-1.044,P=0.297]、SCWT [(9.50±9.28)vs(5.94±10.47),t= 1.123,P= 0.268],modified BNT [14(3)vs 13.5(3),Z=-0.727,P=0.467].In patients with CSVD,CCC was positively correlated with scores of Mo CA(r= 0.551,P=0.01)and also with DS-forward(r=0.532,P=0.013)and SCWT(r=-0.487,P=0.040).Logistic regression showed that CCC was an important variable in predicting the possibility of CSVD(B=-1.318,P=0.019,OR = 0.268,95%CI(0.089-0.808)).ConclusionsCompared with the healthy control,the capacity of cognitive control in patients with cerebral vessel disease decreased significantly(P<0.05).The capacity of cognitive control is related to the cognitive impairment in patients with cerebral small vessel disease.CCC can predict the possibility of CSVD.