Magnetic Resonance Study Of Cerebral White Matter Injury And Cognitive Function After Acute Cerebral Infarction

Objective: To investigate the correlation between the structural changes of white matter and cognitive function after acute cerebral infarction.Methods: In this study,including 17 control patients and 40 patients with first acute cerebral infarction,were recruited and divided into the following 5groups: C group,control group;P0 group,cerebral infarction baseline group;P1 Group,cerebral infarction reexamination case group;PN1 group,reexamination of normal cognitive cases group;PA1 group,cognitive abnormality group.Cognitive function assessment and magnetic resonance examination were performed at baseline and one year after the onset of cerebral infarction in the case group and control group.Scanning sequences included conventional sequences(including axial T1 WI,T2WI and T2 FLAIR,sagittal 3D-T1 WI and 3D-FLAIR),DWI,SWI and DKI sequences.Cognitive function was assessed by Mini-mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MOCA).(1)The changes of cognitive function and white matter high signal in group C,P0 and P1 were compared and analyzed.(2)The PN1 group and PA1 group were compared and analyzed to analyze the risk factors related to cognitive impairment after infarction.(3)DKI was used to compare the C group,P0 group and P1 group based on TBSS technology,and the changes of the white matter microstructure of the whole brain were observed at the baseline of cerebral infarction and one year later.(4)DKI was used to compare the PN1 group and the PA1 group based on TBSS technique.The microstructures of the whole brain white matter of the patients with normal cognitive function and abnormal cognitive function one year after the onset of cerebral infarction,as well as the white matter fiber bundles with statistical significance between the groups were observed.Results:(1)The total load of small vessels in the baseline cerebral infarction group was significantly higher than that in the control group,and the volume of white matter high signal(WMH)and cognitive score were significantly higher than that in the baseline cerebral infarction group one year after cerebral infarction.(2)Univariate analysis showed that there were significant differences in diabetes mellitus,years of education,WMH volume,periventricular WMH volume,and whether the infarct was located in the key site between the cognitive impairment group and the cognitive normal group.Logistic regression analysis showed that whether the infarction was located at the critical site was an independent risk factor for cognitive impairment after infarction.(3)There was no statistical difference in TBSS between P0 group and C group.Compared with C group,KFA of some fiber bundles in P1 group was significantly decreased,and the difference was statistically significant.Compared with the TBSS in the P0 group,the KFA of multiple fibrous tracts of the whole brain was significantly decreased in the P1 group,and the difference was statistically significant.(4)Compared with the PN1 group,the KFA of multiple fiber tracts decreased significantly in the PA1 group,and the difference was statistically significant in the body of corpus callosum(BCC),splenium of corpus callosum(SCC),bilateral posterior thalamic radiation(PTR),bilateral cingulum(CG),bilateral superior longitudinal fasciculus(SLF),left corticospinal tract(CST)and left sagittal stratum(SS).Conclusion: Patients with acute cerebral infarction have a relatively high total load of small vessels in the brain,and the WMH of patients after cerebral infarction continues to progress.Among the related factors,whether the infarction is located at a critical site is an independent risk factor for cognitive impairment after infarction.DKI analysis white matter fiber tracts based on tract-based spatial statistics(TBSS)showed that cerebral infarction damage was not only limited to the primary lesion,but could also occur in white matter far away from the primary lesion and even in the whole brain fiber network.Strategic infarction can cause damage to key white matter fiber bundles.Although the cognitive score increased from baseline at one year after infarction,the white matter microstructural damage was more severe than at baseline,requiring attention to its adverse impact on patients’ long-term cognitive function.