ischemic leukoencephalopathy in patients with visual-spatial working memory event-related potential study

Title: ischemic leukoencephalopathy in patients with visual-spatial working memory event-related potential studyAuthor: Jiang WeiDegree-granting units: Third Military Medical UniversityKey words: ischemic leukoencephalopathy;; visual-spatial working memory;; event-related potentials;; delayed sample matching paradigm;; magnetic resonance diffusion tensor imaging;; vascular cognitive impairment;; frontal - subcortical loopsSummary:Objective:Currently the diagnosis of vascular cognitive impairment, based on research-based information on Alzheimer's disease, early detection and timely treatment difficult. This article explores the ischemic white matter damage is the pathological basis of Magnetic lifter visual spatial working memory characteristics of event-related potentials to find early detection and evaluation of ischemic leukoencephalopathy in patients with cognitive changes of the new methods to improve the diagnosis of vascular cognitive impairment level.Method:13 confirmed by brain magnetic resonance conventional mild ischemic white matter damage, 11 with moderate to severe ischemic white matter damage, 12 were normal elderly head MRI scan as the control group, matched two groups of age, sex, education and ventricle / brain ratio. All subjects completed a series of neuropsychological test scale (questionnaire version of the neuropsychiatric questionnaire, Hamilton Depression Rating Scale, Mini Mental State Examination, Instrumental Activities of Daily Living Scale, Hachinski ischemic index scale, Montreal recognition know the rating scale, Wechsler Adult Intelligence Scale (digit span, digit symbol, picture fills, and block design), the connection test A, word fluency test), visual-spatial working memory test event-related http://www.999magnet.com/products/131-magnetic-lifter potential (2 goals and 3 ball memory load) and magnetic resonance diffusion tensor imaging. Results:
1 Condition Assessment of cognitive function(1) compared with the norm: MoCA score: control group (26.00 ± 1.94), overall cognitive function was normal, mild (23.31 ± 3.68) and moderate to severe (21.27 ± 4.41) ischemic leukoencephalopathy group, the performance of recognition known dysfunction. Connection test A: control group (61.70 ± 18.29) close to normal, mild group (89.00 ± 52.46) and in the severe group (117.82 ± 57.92), prompt cognitive impairment. Verbal fluency test: three groups were 42.80 ± 7.10,37.23 ± 6.46,32.82 ± 6.84, did not find cognitive change.(2) ischemic leukoencephalopathy group and control group: MoCA - abstract score, mild group (p <0.05) and in the severe group (p = 0.52) lower than the control group, no statistical difference between the two groups of patients significance. WAIS - recite digit span score, moderate and severe group than in mild group, the rest was no significant difference between the two groups. WAIS - along back digit span, digit symbol, picture fill and block design, with the degree of ischemic white matter damage increase, 3 groups were followed by deterioration of cognitive performance test, the difference was not statistically significant.(2) analysis of event-related potentialsDelay in the memory phase, identified three waves: N330, P420 and late negative component. 2 ball memory load, in the frontal, right frontal lobe, occipital lobe of the N330 amplitude in the control group than in mild ischemic white matter damage group (all P <0.01) and moderate to severe ischemic white matter damage group (both as P <0.05), the difference was statistically significant; the difference between the two groups were not statistically significant. The left frontal lobe (P <0.05), the central area (P <0.05), parietal (P <0.01), left temporal lobe (P <0.05) N330 amplitude in the control group than in mild ischemic white matter damage group, the difference statistically significant; the other two groups no significant difference between the. In other indicators, were not found for ischemic leukoencephalopathy screening group and control group were significant.3 patients with ischemic leukoencephalopathy observation of DTIThe left knee and hind limbs of internal capsule FA values: in the severe group than the control group (knee P <0.001, hind P <0.01) and the mild group (knee P <0.001, hind P <0.05), the difference was statistically significance. The left putamen and the left globus pallidus ADC value: control group (putamen P <0.05, globus pallidus P <0.001) and the mild group (putamen P <0.01, globus pallidus P <0.001) than in the severe group, difference was statistically significant; right putamen ADC value: the control group than in the severe group (P <0.01), the difference was statistically significant; the right globus pallidus, the ADC value: mild group than in the severe group (P < 0.05), the difference was statistically significant; the left hind limb of internal capsule ADC value: mild group (P <0.05) and in the severe group (P <0.001) than the control group, the difference was statistically significant. The above comparison, the remaining 2 no significant difference between the groups.4.N330 volatility and cognitive assessment scale correlation between theAnd MoCA - delayed recall was significantly related to: the frontal (r =- 0.45), right frontal (r =- 0.49), occipital (r =- 0.41) (both P <0.05); and connection A significant correlation test are: the frontal lobe (r = 0.51), right frontal lobe (r = 0.51), occipital (r = 0.48), parietal (r = 0.44), right temporal lobe (r = 0.37) ( both P <0.01); and digital symbol coding test is significantly related to: the frontal, right frontal lobe (the first two, r =- 0.45), occipital (r =- 0.44) (the first three, P < 0.01), parietal (r =- 0.41), left temporal lobe (r =- 0.38), right temporal lobe (r =- 0.41) (the latter three, P <0.05); and along the back digit span test was significantly related the occipital lobe (r =- 0.37, P <0.05).5.DTI data and cognitive assessment scale correlation and regression analysis(1) FA values: the only access to MoCA (depending on room / Executive, delayed recall, total score) regression equations and the connection test A regression equation is: right hind limb of internal capsule; unique and MoCA - attention and WAIS- - Mapping is significantly related to: the right hind limb of internal capsule; unique and MoCA - is significantly related to language: the left globus pallidus. The only access to WAIS - recite digit span test of the regression equation is: right thalamus; unique and WAIS - a significant number of symbols is related to: the right knee of internal capsule.(2) ADC value: the only access to MoCA - delayed recall and total regression equation is: the right internal capsule, knee; the only access to MoCA - as the space / execute the regression equation is: right putamen; CD entered the MoCA - abstract regression equation is: the left limb of internal capsule; the only access to MoCA - directional regression equation is: left thalamus. A connection test to enter the regression equation are: the right knee and right internal capsule, globus pallidus. Into the verbal fluency test followed by the regression equation is: right hind limb of internal capsule and internal capsule left knee. The only access to WAIS - recite digit span regression equation is: the left globus pallidus, the only access to WAIS - digital symbolic regression equation is: the right ventricle anterior horn, the only access to WAIS - mapping of regression equation is: the left putamen.6.DTI data and ERP indicators of correlation and regression analysisAnd right frontal N330 amplitude was significantly related to FA values, in accordance with the correlation coefficient in the order: the right hind limb of internal capsule, left caudate, right caudate nucleus, right globus pallidus, one of the only into the right frontal N330 volatility regression equation is the right hind limb of internal capsule. The only thing in the frontal N330 amplitude is related to FA values ​​in the right hind limb of internal capsule. FA values ​​in the right putamen and whole brain eight sites in five parts (left frontal lobe, the central part, parietal, occipital, right temporal lobe) N330 amplitude was significantly correlated. And the left temporal lobe was significantly related to are: the right globus pallidus and the left caudate nucleus of FA posterior horn of the left ventricle and the ADC value; and right temporal lobe is significantly related to: the right putamen and left caudate nucleus FA values.Conclusion:1 in patients with ischemic leukoencephalopathy: lower overall cognitive function (MoCA cognitive assessment scale - total score); reduced visual-spatial ability (connection test A); verbal fluency (animals, fruits, vegetable extracts) relatively intact . Ischemic leukoencephalopathy patients than the control group: reduced ability to abstract reasoning (MoCA Cognitive Assessment Scale - abstract); reduced ability to visual-spatial working memory (ERP-the frontal, right frontal and occipital N330 amplitude). A fusion of ischemic white matter lesions in patients with brain lesions than those without fusion of ischemic leukoencephalopathy in patients with lower working memory capacity (WASI-RC-recite digit span test).2.MoCA Cognitive Assessment Scale and the connection test A can identify those with mild ischemic leukoencephalopathy in patients with cognitive impairment.3.DMS paradigm induced visual spatial working memory delay period ERP indicators - N330 amplitude for ischemic leukoencephalopathy in patients with cognitive function assessment.4 in the frontal, right frontal and bilateral occipital N330 amplitude was significantly reduced white matter ischemic damage is the pathological basis of visual spatial working memory ERP characteristics, can be used as evaluation of ischemic leukoencephalopathy in patients with visual-spatial working electrophysiological indicators of memory impairment. In the frontal lobe and right frontal N330 amplitude decreased, neuropathological basis for the projection of the right hind limb of internal capsule fiber damage.5.DTI technology can reflect the normal conventional brain MRI shows subtle changes in brain tissue, to reflect the frontal - subcortical neural circuits of the injury.6 visual-spatial working memory and the "dorsolateral prefrontal circuit," the integrity of the.Degree Year: 2009