Effect of total magnetic resonance imaging burden on the cognitive function in patients with cerebral small vessel diseases

doi:10.3969/j.issn.1004-583X.2023.11.004

Abstract

Abstract:

Objective To explore the correlation between total cerebral magnetic resonance imaging (MRI) burden and cognitive function in patients with cerebral small vessel diseases (CSVDs). Methods A total of 227 CSVD patients diagnosed by the brain MRI and hospitalized in the Department of Neurology from September 2021 to October 2022 were recruited. Their clinical data, brain imaging data, and hematological indicators were collected. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) scale. The correlation between MRI markers and cognitive dysfunction was explored. Results The multivariate analysis showed that age, hypertension, homocysteine (HCY), uric acid (UA), lacunar stroke score (Lac) and total burden of CSVDs were all significantly correlated with the MoCA score ( $P$ <0.05). When other variables remained unchanged, the MoCA score decreased by 2.27 points for each point increase in the total burden of CSVD. The MoCA score decreased by 0.74 points for each point increase in the Lac score. The MoCA score decreased by 0.94 points for patients with a history of hypertension compared with those lacking the history of hypertension. The MoCA score decreased by 0.01 points and 0.07 points for each unit increase in UA and HCY levels, respectively. The MoCA score decreased by 0.07 points for one year older. Overall, all predictors explained the 55.1% decrease in MoCA scores. Conclusion The cognitive function of CSVD patients is affected by many factors, and the brain MRI visualizes the intracranial pathological state. It is suggested that the total burden of brain MRI has an early warning significance for cognitive decline.

Key words: cerebral small vessel disease, total MRI burden, cognitive function, MoCA scale

CLC Number:

R743

Zhu Fangfang, Wei Xuezhi, Feng Min. Effect of total magnetic resonance imaging burden on the cognitive function in patients with cerebral small vessel diseases[J]. Clinical Focus, 2023, 38(11): 984-990.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.11.004

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I11/984

Figures/Tables 7

Tab.1 Comparison of clinical data and imaging indicators between the two groups

项目	认知障碍组 ( $n$ =100)	认知正常组 ( $n$ =127)	χ²/ $t$ / $F$ 值	$P$ 值
性别[例(%)]
男女	69(69.0) 31(31.0)	87(68.5) 40(31.5)	0.011	1.000
年龄( $x -$ ±s)	69.00±6.73	64.80±6.66	0.619	<0.01
教育年限( $x -$ ±s)	9.39±3.35	9.35±3.05	0.014	0.919
吸烟[例(%)]
无有	45(45.0) 55(55.0)	77(60.6) 50(39.4)	0.317	0.023
饮酒[例(%)]
无有	62(62.0) 38(38.0)	75(59.1) 52(40.9)	0.060	0.683
高血压病[例(%)]
无有	43(43.0) 57(57.0)	79(62.2) 48(37.8)	0.392	0.005
冠心病[例(%)]
无有	57(57.0) 43(43.0)	81(63.8) 46(36.2)	0.139	0.339
糖尿病[例(%)]
无有	63(63.0) 37(37.0)	76(59.8) 51(40.2)	0.065	0.681
卒中史[例(%)]
无有	53(53.0) 47(47.0)	76(59.8) 51(40.2)	0.138	0.345
TG(mmol/L)	2.17±0.71	2.04±0.67	0.198	0.140
CHOL(mmol/L)	4.85±1.07	4.57±1.12	0.258	0.055
HDL(mmol/L)	1.93±0.51	1.89±0.52	0.081	0.544
LDL(mmol/L)	2.49±1.12	2.44±1.02	0.051	0.702
HCY(mmol/L)	17.20±6.16	14.00±5.84	0.533	<0.01
UA(mmol/L)	396.00±65.50	378.00±69.20	0.262	0.050
FBG(mmol/L)	6.01±1.12	5.89±0.97	0.110	0.407
Lac评分(分)	0.70±0.46	0.50±0.50	0.423	0.002
CMBs评分[M(P25, P75)]	0.00 (0.00,1.00)	0.00 (0.00,0.00)	0.409	0.002
WMH评分( $x -$ ±s)	0.69±0.46	0.35±0.48	0.710	<0.01
EPVS评分( $x -$ ±s)	0.28±0.45	0.27±0.44	0.027	0.838
CSVD总负荷[M(P25, P75)]	2.00(1.00,2.00)	1.00 (1.00,1.50)	1.101	<0.01

Tab.1 Comparison of clinical data and imaging indicators between the two groups

项目	认知障碍组 ( $n$ =100)	认知正常组 ( $n$ =127)	χ²/ $t$ / $F$ 值	$P$ 值
性别[例(%)]
男女	69(69.0) 31(31.0)	87(68.5) 40(31.5)	0.011	1.000
年龄( $x -$ ±s)	69.00±6.73	64.80±6.66	0.619	<0.01
教育年限( $x -$ ±s)	9.39±3.35	9.35±3.05	0.014	0.919
吸烟[例(%)]
无有	45(45.0) 55(55.0)	77(60.6) 50(39.4)	0.317	0.023
饮酒[例(%)]
无有	62(62.0) 38(38.0)	75(59.1) 52(40.9)	0.060	0.683
高血压病[例(%)]
无有	43(43.0) 57(57.0)	79(62.2) 48(37.8)	0.392	0.005
冠心病[例(%)]
无有	57(57.0) 43(43.0)	81(63.8) 46(36.2)	0.139	0.339
糖尿病[例(%)]
无有	63(63.0) 37(37.0)	76(59.8) 51(40.2)	0.065	0.681
卒中史[例(%)]
无有	53(53.0) 47(47.0)	76(59.8) 51(40.2)	0.138	0.345
TG(mmol/L)	2.17±0.71	2.04±0.67	0.198	0.140
CHOL(mmol/L)	4.85±1.07	4.57±1.12	0.258	0.055
HDL(mmol/L)	1.93±0.51	1.89±0.52	0.081	0.544
LDL(mmol/L)	2.49±1.12	2.44±1.02	0.051	0.702
HCY(mmol/L)	17.20±6.16	14.00±5.84	0.533	<0.01
UA(mmol/L)	396.00±65.50	378.00±69.20	0.262	0.050
FBG(mmol/L)	6.01±1.12	5.89±0.97	0.110	0.407
Lac评分(分)	0.70±0.46	0.50±0.50	0.423	0.002
CMBs评分[M(P25, P75)]	0.00 (0.00,1.00)	0.00 (0.00,0.00)	0.409	0.002
WMH评分( $x -$ ±s)	0.69±0.46	0.35±0.48	0.710	<0.01
EPVS评分( $x -$ ±s)	0.28±0.45	0.27±0.44	0.027	0.838
CSVD总负荷[M(P25, P75)]	2.00(1.00,2.00)	1.00 (1.00,1.50)	1.101	<0.01

Tab. 2 Multivariate regression results for model 1

变量		β值	$t$ 值	$P$ 值	95% $C I$
变量		β值	$t$ 值	$P$ 值	下限	上限
年龄	[49, 83]	-0.07	-3.495	<0.01	-0.11	-0.03
吸烟	0( $n$ =122) 1( $n$ =105)	0.01	0.050	0.961	-0.52	0.55
高血压病	0( $n$ =122) 1( $n$ =105)	-0.96	-3.545	<0.01	-1.49	-0.43
HCY	[4, 46]	-0.06	-2.857	0.005	-0.11	-0.02
UA	[226, 656]	-0.00	-2.500	0.013	-0.01	-0.00
CHOL	[2.5, 7.6]	-0.17	-1.432	0.154	-0.41	0.07
Lac评分	[0, 1]	-0.83	-2.360	0.019	-1.52	-0.14
CMBs评分	[0, 1]	0.38	0.826	0.410	-0.53	1.29
WMH评分	[0, 1]	-0.48	-1.230	0.220	-1.25	0.29
CSVD评分	[1, 4]	-2.20	-6.658	<0.01	-2.85	-1.55

Tab. 2 Multivariate regression results for model 1

变量		β值	$t$ 值	$P$ 值	95% $C I$
变量		β值	$t$ 值	$P$ 值	下限	上限
年龄	[49, 83]	-0.07	-3.495	<0.01	-0.11	-0.03
吸烟	0( $n$ =122) 1( $n$ =105)	0.01	0.050	0.961	-0.52	0.55
高血压病	0( $n$ =122) 1( $n$ =105)	-0.96	-3.545	<0.01	-1.49	-0.43
HCY	[4, 46]	-0.06	-2.857	0.005	-0.11	-0.02
UA	[226, 656]	-0.00	-2.500	0.013	-0.01	-0.00
CHOL	[2.5, 7.6]	-0.17	-1.432	0.154	-0.41	0.07
Lac评分	[0, 1]	-0.83	-2.360	0.019	-1.52	-0.14
CMBs评分	[0, 1]	0.38	0.826	0.410	-0.53	1.29
WMH评分	[0, 1]	-0.48	-1.230	0.220	-1.25	0.29
CSVD评分	[1, 4]	-2.20	-6.658	<0.01	-2.85	-1.55

Fig.1 Forest diagram of model 1

Tab. 3 Multivariate regression results for model 2

变量		β值	$t$ 值	$P$ 值	95% $C I$
变量		β值	$t$ 值	$P$ 值	下限	上限
年龄	[49, 83]	-0.07	-3.57	<0.01	-0.11	0.03
高血压病	0( $n$ =122) 1( $n$ =105)	-0.94	-3.47	<0.01	-1.48	-0.41
HCY	[4, 46]	-0.07	-3.10	0.002	-0.11	-0.03
UA	[226, 656]	-0.01	-2.53	0.012	-0.01	-0.00
Lac评分	[0, 1]	-0.74	-2.65	0.009	-1.28	-0.19
CSVD总负荷	[1, 4]	-2.27	-11.43	<0.01	-2.66	-1.88

Tab. 3 Multivariate regression results for model 2

变量		β值	$t$ 值	$P$ 值	95% $C I$
变量		β值	$t$ 值	$P$ 值	下限	上限
年龄	[49, 83]	-0.07	-3.57	<0.01	-0.11	0.03
高血压病	0( $n$ =122) 1( $n$ =105)	-0.94	-3.47	<0.01	-1.48	-0.41
HCY	[4, 46]	-0.07	-3.10	0.002	-0.11	-0.03
UA	[226, 656]	-0.01	-2.53	0.012	-0.01	-0.00
Lac评分	[0, 1]	-0.74	-2.65	0.009	-1.28	-0.19
CSVD总负荷	[1, 4]	-2.27	-11.43	<0.01	-2.66	-1.88

Fig. 2 Forest diagram of model 2

Fig.3 Linear regression model for model 2 Blue represents the regression curve, red represents the prediction interval, and gray represents the confidence interval

Fig.4 Regression diagnosis diagram of MoCA score on model 2

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