UNASSIGNED: To investigate association of cerebral hypoperfusion and poor collaterals with vascular cognitive impairment (VCI) in severe VBA stenosis patients.
UNASSIGNED: We consecutively enrolled patients with severe VBA stenosis confirmed by digital subtraction angiography who underwent computed tomographic perfusion (CTP) and cognitive assessments. Patients were divided into poor or good collaterals groups according to the collateral circulation status, and were grouped into different perfusion groups according to CTP. Cognitive function was measured by Montreal Cognitive Assessment (MoCA), Clock Drawing Test, Stroop Color Word Test, Trail Making Test, Digital Span Test, Auditory Verbal Learning Test, and Boston Naming Test scales. The association of cerebral perfusion and collaterals with VCI were explored.
UNASSIGNED: Among 88 eligible patients, VCI occurred in 51 (57.9%) patients experienced. Poor collateral was present in 73 (83.0%) patients, and hypoperfusion in 64 (72.7%). Compared with normal perfusion patients, the odds ratio with 95% confidence interval for VCI was 12.5 (3.7-42.4) for overall hypoperfusion, 31.0 (7.1-135.5) for multiple site hypoperfusion, 3.3 (1.0-10.5) for poor collaterals, and 0.1 (0-0.6) for presence of posterior communicating artery (PcoA) compensated for posterior cerebral artery (PCA) and basilar artery (BA). Additionally, decreased scores of cognitive function tests occurred in patients with decompensated perfusion or poor collaterals.
UNASSIGNED: Hypoperfusion and poor collaterals were positively associated with cognitive impairment in patients with severe VBA. However, PcoA compensated for the PCA and BA had a protective role in cognitive impairment development.
■探讨严重VBA狭窄患者脑内灌注不足和络脉不良与血管性认知障碍(VCI)的关系。
■我们连续纳入经数字减影血管造影证实的严重VBA狭窄患者,这些患者接受了计算机断层扫描灌注(CTP)和认知评估。根据侧支循环状态将患者分为欠支或优支组,并根据CTP分为不同的灌注组。认知功能通过蒙特利尔认知评估(MoCA)测量,时钟绘制测试,Stroop颜色单词测试,跟踪测试,数字跨度测试,听觉语言学习测试,和波士顿命名测试量表。探讨了脑灌注和络脉与VCI的关系。
■在88名符合条件的患者中,51例(57.9%)患者发生VCI。73例(83.0%)患者存在不良侧支,64例(72.7%)灌注不足。与正常灌注患者相比,对于总体灌注不足,VCI的比值比为95%置信区间为12.5(3.7-42.4),31.0(7.1-135.5)用于多部位灌注不足,3.3(1.0-10.5)适用于较差的抵押品,和0.1(0-0.6)的存在后交通动脉(PcoA)补偿大脑后动脉(PCA)和基底动脉(BA)。此外,在灌注失代偿或经络不良的患者中,认知功能测试得分降低.
■严重VBA患者的低灌注和欠周与认知障碍呈正相关。然而,PcoA补偿PCA,BA在认知障碍发展中具有保护作用。