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Abstract：
OBJECTIVE: This study investigated the correlation between the pulsatility index (PI) of the middle cerebral artery with the total burden of cerebral small vessel disease and cognitive impairment.
METHODS: Information on patients hospitalized in the Department of Neurology was collected retrospectively. These patients had complete clinical and laboratory data. The middle cerebral artery PI was measured using transcranial Doppler, a Mini-Mental State Examination (MMSE) was used to assess cognitive function, and the total cerebral small vessel disease burden was assessed using magnetic resonance imaging. Patients were grouped according to their scores for total imaging burden of cerebral small vessel disease and cognitive function. Logistic regression analysis assessed the association between the PI, total imaging burden, and cognitive impairment. Spearman analysis was used to evaluate the correlation between the PI and total imaging burden and cognitive impairment, and receiver operating characteristic (ROC) curves were used to determine the predictive value of the PI for cognitive function.
RESULTS: The PI was higher in the cognitive impairment (CI) group than in the no-CI group. Binary logistic regression analysis showed that increased PI was an independent risk factor for CI (OR = 1.582; 95% CI: 1.043-2.401; p = .031) and total imaging burden (OR = 1.842; 95% CI: 1.274-2.663; p = .001). Spearman analysis found that the PI correlated negatively with the MMSE score (r = -.627, p < .001). ROC curve analysis showed the PI predicted CI with an area under the curve of 0.784. The PI combined with the total imaging burden predicted CI in cerebral small vessel disease with an area under the curve of 0.832.
CONCLUSIONS: An increased PI was associated with CI and a high imaging burden in cerebral small vessel disease patients. The PI combined with the total burden score shows a high predictive value for CI.
METHODS: Information on patients hospitalized in the Department of Neurology was collected retrospectively. These patients had complete clinical and laboratory data. The middle cerebral artery PI was measured using transcranial Doppler, a Mini-Mental State Examination (MMSE) was used to assess cognitive function, and the total cerebral small vessel disease burden was assessed using magnetic resonance imaging. Patients were grouped according to their scores for total imaging burden of cerebral small vessel disease and cognitive function. Logistic regression analysis assessed the association between the PI, total imaging burden, and cognitive impairment. Spearman analysis was used to evaluate the correlation between the PI and total imaging burden and cognitive impairment, and receiver operating characteristic (ROC) curves were used to determine the predictive value of the PI for cognitive function.
RESULTS: The PI was higher in the cognitive impairment (CI) group than in the no-CI group. Binary logistic regression analysis showed that increased PI was an independent risk factor for CI (OR = 1.582; 95% CI: 1.043-2.401; p = .031) and total imaging burden (OR = 1.842; 95% CI: 1.274-2.663; p = .001). Spearman analysis found that the PI correlated negatively with the MMSE score (r = -.627, p < .001). ROC curve analysis showed the PI predicted CI with an area under the curve of 0.784. The PI combined with the total imaging burden predicted CI in cerebral small vessel disease with an area under the curve of 0.832.
CONCLUSIONS: An increased PI was associated with CI and a high imaging burden in cerebral small vessel disease patients. The PI combined with the total burden score shows a high predictive value for CI.
摘要：
目的：本研究探讨了大脑中动脉搏动指数（PI）与脑小血管病总负担和认知障碍的相关性。
方法：回顾性收集神经内科住院患者的资料。这些患者具有完整的临床和实验室数据。经颅多普勒测量大脑中动脉PI,使用简易精神状态检查(MMSE)来评估认知功能，并使用磁共振成像评估脑小血管疾病总负担。根据脑小血管病的总影像学负荷和认知功能评分对患者进行分组。Logistic回归分析评估了PI，总成像负担，和认知障碍。采用Spearman分析评价PI与总成像负担和认知障碍的相关性,和受试者工作特征（ROC）曲线用于确定PI对认知功能的预测价值。
结果：认知障碍（CI）组的PI高于非CI组。二元logistic回归分析显示，PI升高是CI（OR=1.582；95%CI：1.043-2.401；p=0.031）和总影像学负担（OR=1.842；95%CI：1.274-2.663；p=.001）的独立危险因素。Spearman分析发现PI与MMSE评分呈负相关(r=-.627,p<.001)。ROC曲线分析显示PI预测CI的曲线下面积为0.784。PI结合总成像负荷预测脑小血管病CI的曲线下面积为0.832。
结论：脑小血管病患者的PI升高与CI和高影像学负担相关。PI与总负担评分相结合对CI具有较高的预测价值。
方法：回顾性收集神经内科住院患者的资料。这些患者具有完整的临床和实验室数据。经颅多普勒测量大脑中动脉PI,使用简易精神状态检查(MMSE)来评估认知功能，并使用磁共振成像评估脑小血管疾病总负担。根据脑小血管病的总影像学负荷和认知功能评分对患者进行分组。Logistic回归分析评估了PI，总成像负担，和认知障碍。采用Spearman分析评价PI与总成像负担和认知障碍的相关性,和受试者工作特征（ROC）曲线用于确定PI对认知功能的预测价值。
结果：认知障碍（CI）组的PI高于非CI组。二元logistic回归分析显示，PI升高是CI（OR=1.582；95%CI：1.043-2.401；p=0.031）和总影像学负担（OR=1.842；95%CI：1.274-2.663；p=.001）的独立危险因素。Spearman分析发现PI与MMSE评分呈负相关(r=-.627,p<.001)。ROC曲线分析显示PI预测CI的曲线下面积为0.784。PI结合总成像负荷预测脑小血管病CI的曲线下面积为0.832。
结论：脑小血管病患者的PI升高与CI和高影像学负担相关。PI与总负担评分相结合对CI具有较高的预测价值。
