Effect of infarct size on cognitive impairment in patients with acute temporal and occipital lobe infarction and its relationship with event-related potential P300 latency
Yang Jingfeng, Miao Qing
Department of Neurology, Bengbu Third People's Hospital, Affiliated to Bengbu Medical College, Bengbu 233000, China
Abstract:Objective This study aimed to explore the effect of the size of acute temporal lobe or occipital lobe infarction on cognitive dysfunction, and analyze the relationship between event-related potential P300 latency and cognitive dysfunction. Methods In this study, a prospective study design was used. A total of 100 patients with acute temporal lobe or occipital lobe infarction who were admitted to the Department of Neurology, Bengbu Third People's Hospital, from January 2020 to July 2021 were included as the research objects, including 52 males and 48 females, with an age range of 50-82 years (70.2±7.9). All patients had 5-9 (5.3±0.9) years of education; 21 patients had a history of smoking; 17 patients had a history of drinking; 36 patients had a history of hypertension; 24 patients had a history of diabetes, and 10 patients had a history of coronary heart disease. In addition, all patients underwent brain MRI scans, and they were grouped on the basis of the size of the infarct: observation group A (41 cases) with infarction ≥30 cm3 and observation group B (59 cases) with infarction <30 cm3. Fifty age-matched healthy subjects in the same hospital were selected as the control group, including 25 males and 25 females, aged 50-82 (71.3±7.2) years old. The clinical baseline data such as gender, age, years of education, smoking history, drinking history, hypertension, diabetes mellitus, and coronary heart disease history were compared among the three groups; the Montreal Cognitive Assessment (MoCA) scale was used to evaluate the cognition of all subjects, and the P300 incubation period of all subjects was measured. The observation group was tested when the condition was stable after 1 week of hospitalization, and the control group was tested on the day of physical examination. Spearman correlation analysis was used to evaluate the correlation between P300 latency and MoCA score of cognitive impairment patients in the observation group. Results No significant difference in baseline data was found among the three groups (all P>0.05). The MoCA scores of observation group A, observation group B, and the control group were 27(23,28), 28(27,29), and 29(28,30), respectively. The P300 latency was 380(320,380) ms、310( 290,350) ms and 290(280,300) ms, respectively, and the incidence of cognitive disorder was 43.9% (18/41), 32.2% (19/59), and 2% (1/50), respectively. Compared with the two observation groups, patients in the control group had higher MoCA score, shorter P300 latency, and lower incidence of cognitive impairment, with statistically significant differences among the three groups (Z=34.29, Z=64.00, χ2=23.34, all P values <0.001). Compared with observation group B, observation group A had lower MoCA score and longer P300 latency, and the differences were statistically significant (all P values <0.001). Spearman correlation analysis showed that the MoCA score [25(22, 27)] of patients with cognitive impairment in the observation group was negatively correlated with P300 latency [360(320, 416) ms] (rs=-0.36, P <0.05). Conclusion The size of acute temporal lobe or occipital lobe infarction has an influence on the cognitive impairment of patients. In addition, the P300 latency is negatively correlated with the score of MoCA scale which shows consistent results during evaluation.
杨敬凤, 苗青. 梗死灶大小对急性颞叶或枕叶梗死患者认知障碍的影响及其与事件相关电位P300潜伏期的关系[J]. 中华解剖与临床杂志, 2022, 27(10): 715-720.
Yang Jingfeng, Miao Qing. Effect of infarct size on cognitive impairment in patients with acute temporal and occipital lobe infarction and its relationship with event-related potential P300 latency. Chinese Journal of Anatomy and Clinics, 2022, 27(10): 715-720.
王拥军, 李子孝, 谷鸿秋, 等. 中国卒中报告2019(中文版)(3)[J].中国卒中杂志,2020,15(12):1251-1263. DOI: 10.3969/j.issn.1673-5765.2020.12.001.15(12):1251-1263. DOI10.3969/j.issn.1673-5765.2020.12.001.Wang YJ, Li ZX, Gu HQ, et al.China Stroke Report 2019 (Chinese version)(3)[J]. China Stroke Journal, 2020,15(12):1251-1263. DOI: 10.3969/j.issn.1673-5765.2020.12.001.15(12):1251-1263. DOI:10.3969/j.issn.1673-5765.2020.12.001.
[2]
Wang YJ, Li ZX, Gu HQ, et al.China stroke statistics 2019: a report from the National Center for Healthcare Quality Management in Neurological Diseases, China National Clinical Research Center for Neurological Diseases, the Chinese Stroke Association, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention and Institute for Global Neuroscience and Stroke Collaborations[J]. Stroke Vasc Neurol, 2020,5(3):211-239. DOI: 10.1136/svn-2020-000457.
[3]
Mijajlović MD, Pavlović A, Brainin M, et al.Post-stroke dementia-a comprehensive review[J]. BMC Med, 2017,15(1):11. DOI: 10.1186/s12916-017-0779-7.
[4]
Aldrugh S, Sardana M, Henninger N, et al.Atrial fibrillation, cognition and dementia: a review[J]. J Cardiovasc Electrophysiol, 2017,28(8):958-965. DOI: 10.1111/jce.13261.
Mok VC, Lam BY, Wong A, et al.Early-onset and delayed-onset poststroke dementia-revisiting the mechanisms[J]. Nat Rev Neurol, 2017,13(3):148-159. DOI: 10.1038/nrneurol.2017.16.
[7]
Campanholo KR, Conforto AB, Rimkus CM, et al.Cognitive and functional impairment in stroke survivors with basilar artery occlusive disease[J]. Behav Neurol, 2015,2015:971514. DOI: 10.1155/2015/971514.
[8]
Busigny T, Pagès B, Barbeau EJ, et al.A systematic study of topographical memory and posterior cerebral artery infarctions[J]. Neurology, 2014,83(11):996-1003. DOI: 10.1212/WNL.0000000000000780.
[9]
Farrar DC, Mian AZ, Budson AE, et al.Retained executive abilities in mild cognitive impairment are associated with increased white matter network connectivity[J]. Eur Radiol, 2018,28(1):340-347. DOI: 10.1007/s00330-017-4951-4.
[10]
孙跃岐, 吕春梅, 朱江华, 等. 蒙特利尔认知量表在健康体检老年人群中的应用[J].中国老年保健医学,2018,12(6):12-13. DOI: 10.3969/j.issn.1672-2671.2018.06.004.Sun YQ, Lyu CM, Zhu JH, et al.Application of Montreal cognition scale on health examination in elderly population[J]. Chinese Journal of Geriatric Care,2018,12(6):12-13. DOI: 10.3969/j.issn.1672-2671.2018.06.004.
[11]
任庆国, 梁兵, 孟祥水. 血管性认知障碍临床诊断标准概述[J].实用医学杂志,2019,3 5(1): 1-3. DOI:10.3969/j.issn.1006-5725.2019.01.001.Ren QG, Liang B, Meng XS.Overview of clinical diagnostic criteria for vascular cognitive impairment[J]. Journal of Practical Medicine,2019,35(01):1-3. DOI:10.3969/j.issn. 1006-5725.2019.01.001.
[12]
Mellon L, Brewer L, Hall P, et al.Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study[J]. BMC Neurol, 2015,15:31. DOI: 10.1186/s12883-015-0288-2.
[13]
Davydow DS, Levine DA, Zivin K, et al.The association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: a cohort study[J]. Psychosom Med, 2015,77(2):200-208. DOI: 10.1097/PSY.0000000000000136.
[14]
Guajardo VD, Terroni L, Sobreiro Mde F, et al.The influence of depressive symptoms on quality of life after stroke: a prospective study[J]. J Stroke Cerebrovasc Dis, 2015,24(1):201-209. DOI: 10.1016/j.jstrokecerebrovasdis.2014.08.020.
[15]
阮婕, 计仁杰, 魏果, 等. 后循环缺血性卒中与认知障碍相关性研究[J].中国卒中杂志,2015,(12):1012-1018. DOI: 10.3969/j.issn.1673-5765.2015.12.006.Ran J, Ji RJ, Wei G, et al.Correlation of posterior cerebral artery ischemic stroke and cognitive impairment[J]. Chinese Journal of Stroke,2015,(12):1012-1018. DOI: 10.3969/j.issn.1673-5765.2015.12.006.
[16]
Oyegbile TO, VanMeter JW, Motamedi G, et al. Executive dysfunction is associated with an altered executive control network in pediatric temporal lobe epilepsy[J]. Epilepsy Behav, 2018,86:145-152. DOI: 10.1016/j.yebeh.2018.04.022.
[17]
Tagawa R, Hashimoto H, Nakanishi A, et al.The relationship between medial temporal lobe atrophy and cognitive impairment in patients with dementia with Lewy bodies[J]. J Geriatr Psychiatry Neurol, 2015,28(4):249-254. DOI: 10.1177/0891988715590210.
[18]
李先锋, 周凤坤, 吴李硕, 等. 缺血性卒中患者认知功能障碍的危险因素分析[J].临床荟萃,2020,35(1):37-40. DOI: 10.3969/j.issn.1004-583X.2020.01.006.Li XF, Zhou FK, Wu LS, et al.Risk factors for cognitive impairment inpatients with ischemic stroke[J].Clinical Focus,2020,35(1):37-40. DOI: 10.3969/j.issn.1004-583X.2020.01.006.
[19]
阎艳. 不同梗死部位的急性脑梗死患者血管性认知障碍的特点分析[J]. 临床医药文献电子杂志,2018,5(91):58. DOI:10.3877/j.issn.2095-8242.2018.91.040.Yan Yan.Analysis of the characteristics of vascular cognitive impairment in patients with acute cerebral infarction at different infarct sites[J]. Clinical Medicine Articles Xian Electronic Journal, 2018, 5(91): 58. DOI: 10.3877/j.issn.2095-8242.2018.91.040.
[20]
Rao SM, Leo GJ, Haughton VM, et al.Correlation of magnetic resonance imaging with ne uropsychological testing in multiple sclerosis[J]. Neurology, 1989, 39(2 Pt 1): 161-166. DOI:10.1212/wnl.39.2.161.
[21]
李学, 王建平, 马建军, 等. 急性脑梗死患者影像学分型与认知功能及事件相关电位P300关系的研究[J]. 临床荟萃,2007,(17):1247-1250.DOI:10.3969/j.issn.1673-5110.2006.03.002.Li Xue, Wang JP, Ma JJ, et al.Study on the relationship between imaging classification and cognitive function and event-related potential P300 in patients with acute cerebral infarction[J]. Clinical Metabolism, 2007, (17): 1247-1250. DOI: 10.3969/ j.issn.1673-5110.2006.03.002.
[22]
袁慧贤, 江钢辉. 杨文辉治疗多发脑梗死性痴呆经验[J].吉林中医药,2021,41(12):1587-1589. DOI: 10.13463/j.cnki.jlzyy.2021.12.013.Yuan HX, Jiang GH.Professor Yang Wenhui's experience in the treatment of multiple cerebral infarction dementia[J].Jilin Journal of Traditional Chinese Medicine,2021,41(12):1587-1589. DOI: 10.13463/j.cnki.jlzyy.2021.12.013.
[23]
Winstein CJ, Stein J, Arena R, et al.Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2016,47(6):e98-e169. DOI: 10.1161/STR.0000000000000098.
[24]
Salvadori E, Pasi M, Poggesi A, et al.Predictive value of MoCA in the acute phase of stroke on the diagnosis of mid-term cognitive impairment[J]. J Neurol, 2013,260(9):2220-2227. DOI: 10.1007/s00415-013-6962-7.
[25]
Dong Y, Sharma VK, Chan BP, et al.The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke[J]. J Neurol Sci, 2010,299(1-2):15-18. DOI: 10.1016/j.jns.2010.08.051.
[26]
Cumming TB, Churilov L, Linden T, et al.Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke[J]. Acta Neurol Scand, 2013,128(2):122-129. DOI: 10.1111/ane.12084.
[27]
Godefroy O, Fickl A, Roussel M, et al.Is the Montreal Cognitive Assessment superior to the Mini-Mental State Examination to detect poststroke cognitive impairment? A study with neuropsychological evaluation[J]. Stroke, 2011,42(6):1712-1716. DOI: 10.1161/STROKEAHA.110.606277.
[28]
Hamilton HK, Woods SW, Roach BJ, et al.Auditory and visual oddball stimulus processing deficits in schizophrenia and the psychosis risk syndrome: forecasting psychosis risk with P300[J]. Schizophr Bull, 2019,45(5):1068-1080. DOI: 10.1093/schbul/sby167.
[29]
石晶, 司翠平, 刘茜, 等. 事件相关电位P300在脑认知功能评估中的研究进展[J].中华脑科疾病与康复杂志(电子版),2015,(4):269-272. DOI: 10.3877/cma.j.issn.2095-123X.2015.04.014.Shi J, Si CP, Liu Q, et al.Research progress of event-related potentials P300 applied in brain cognitive function assessment and the related[J]. Chinese Journal of Brain Diseases and Rehabilitatin(Electronic Edition), 2015,(4):269-272. DOI: 10.3877/cma.j.issn.2095-123X.2015.04.014.
[30]
Tang A, Santesso DL, Segalowitz SJ, et al.Distinguishing shyness and sociability in children: an event-related potential study[J]. J Exp Child Psychol, 2016,142:291-311. DOI: 10.1016/j.jecp.2015.08.008.
[31]
Hamilton HK, Roach BJ, Bachman PM, et al.Association between P300 responses to auditory oddball stimuli and clinical outcomes in the psychosis risk syndrome[J]. JAMA Psychiatry, 2019,76(11):1187-1197. DOI: 10.1001/jamapsychiatry.2019.2135.
[32]
任大为, 万继峰, 庄严, 等. 颅内动脉狭窄程度、梗死病灶位置与脑梗死后抑郁的关系[J].血管与腔内血管外科杂志,2021,7(2):226-230. DOI: 10.19418/j.cnki.issn2096-0646.2021.02.22.Ren DW, Wan JF, Zhuang Y, et al.Relationship of intracranial artery stenosis degree and infarct focus location with post-stroke depression[J]. Journal of Vascular and Endovascular Surgery,2021,7(2):226-230. DOI: 10.19418/j.cnki.issn2096-0646.2021.02.22.