The Correlation Between Total Magnetic Resonance Imaging Load Of Cerebral Small Vessel Diseases And Cognitive Impairment Serum MMP-9、BDNF In Cerebral Small Vessel Disease

BackgroundCerebral small vessel diseases(CSVD)is a clinical and pathological syndrome that affects intracranial small vessels.It has a variety of imaging phenotypes,which can lead to cognitive impairment.Matrix metalloproteinase-9(MMP-9)and Brain derived neurotrophic factor(BDNF)play an important role in nerve injury and protection,and may be abnormally expressed in the early stage of clinical symptoms.In the past,there are many studies on the relationship between CSVD single magnetic resonance imaging marker and cognitive function,MMP-9 and BDNF,but there are few studies on the total load of CSVD images as an observation index.Therefore,this study discussed the relationship between the total load of CSVD images and cognitive function,MMP-9 and BDNF,in order to provide clues for early identification of the disease.ObjectiveTo explore the correlation and predictive value between total imageing load and cognitive impairment,serum MMP-9 and BDNF levels in patients with cerebral small vessel diseases.MethodsProspective study included CSVD patients who were treated continuously in the first affiliated Hospital of Xinxiang Medical College from April 2019 to April 2020.All enrolled patients received the head MRI examination,biochemical index test and baseline data collection.They were divided into normal cognitive group and cognitive impairment group according to the score of mini-mental state examination(MMSE).The imaging features of patients with CSVD were evaluated according to the CSVD total load score.The Montreal Cognitive Assessment scale(Mo CA)was used to evaluate the cognitive level.The correlation and predictive value between the total load of CSVD images and cognitive impairment,serum MMP-9 and BDNF levels were analyzed.Results1.A total of 83 patients with CSVD were enrolled,average age of(62.07 ±10.56)years,52 males(62.7%).The incidence of cognitive impairment in all enrolled CSVD patients was 55.4%.2.The imaging load score was 0-2 in 57 cases(68.7%)and 3-4 in 26 cases(31.3%).High load score is common in cognitive impairment group,and cognitive impairment is mainly reflected in attention.3.There was no significant difference in sex,previous disease status,personal bad habits and serum biochemical indexes such as TG,TC,LDL,HDL,GLU and GHb between the two groups.The age,levels of MMP-9 and Hcy in the cognitive impairment group were significantly higher than those in the normal cognitive group,while the levels of education [6.67 ±3.615,8.54 ±3.461] and BDNF [1.10 ±0.33,1.59 ±0.56] in the group B were significantly higher than those in the normal cognitive group.The difference was statistically significant(P < 0.05).4.The levels of serum MMP-9,BDNF,Hcy,and age,educational attainment were negatively correlated with cognitive function(r=-0.270,-0.163,-0.568),while serum BDNF level and education level were positively correlated with cognitive function(r=0.419,0.355).5.Age(OR1.107,95%CI1.034-1.186)and BDNF(OR0.998,95%CI0.996-1.000)are independent influencing factors of cognitive impairment with CSVD.6.The levels of serum MMP-9 has significant significance for the diagnosis of cognitive impairment caused by CSVD(AUC0.693,sensitivity 97.8%,specificity 71.1%)(P < 0.05).Conclusions1.The higher the total imaging load score,the more severe the cognitive impairment,which was mainly reflected in attention.2.The serum levels of BDNF are influencing factors of cognitive impairment with CSVD.