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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2018.00455

Association between cerebral hypoperfusion and cognitive impairment in patients with chronic vertebra-basilar stenosis

 Yiming Deng1, 2, 3, Luyao Wang4, Xuan Sun1, 2, 3, Lian Liu1, 2, 3, Meifang Zhu2, 3, 5,  Chunxue Wang2, 3, 5, Binbin Sui1, 2, 3, Mi Shen1, 2, 3, Weibin Gu1, 2, 3, Dapeng Mo1, 2, 3, Ning Ma1, 2, 3, Ligang Song1, 2, 3, Xiaoqing Li1, 2, 3, Xiaochuan Huo1, 2, 3, Duanduan Chen4, 6* and  Feng Gao1, 2, 3*
  • 1Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China
  • 2China National Clinical Research Center of Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, China
  • 3Center of Stroke, Beijing Institute for Brain Disorders, China
  • 4School of Mechatronical Engineering, Beijing Institute of Technology, China
  • 5Neuropsychiatry and Clinical Psychology, Beijing Tiantan Hospital, China
  • 6Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, the Ministry of Industry and Information Technology, Beijing Institute of Technology, China

Objective: This study aimed to investigate the association between cognitive impairment and cerebral haemodynamic changes in patients with chronic vertebra-basilar (VB) stenosis.
Methods: Patients with severe posterior circulation VB stenosis and infarction or a history of infarction for more than 2 weeks from January 2014 to January 2015 were enrolled (n = 96). They were divided into three groups, namely, the computed tomography perfusion (CTP) normal group, the CTP compensated group, and the CTP decompensated group. Cognitive function was assessed using a validated Chinese version of the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Regression models were used to identify independent risk factors for cognitive impairment.
Results: The MMSE and FAB scores of patients in the CTP decompensated group were significantly lower than those of patients in the CTP normal and CTP compensated groups (all p < 0.05). The RBANS total and its domain scores, including immediate memory, visual acuity, and delayed memory, in the CTP compensated and CTP decompensated groups were significantly lower than those in the CTP normal group (all p < 0.05). Multiple regression analyses showed that CTP compensation, CTP decompensation, severe VB tandem stenosis, and multiple infarctions were independent risk factors for cognitive impairment.
Conclusions: Low perfusion caused by severe VB stenosis can lead to extensive cognitive impairments in areas such as immediate memory, visual span, and delayed memory.

Keywords: vertebra-basilar stenosis, cognitive impairment, cerebral hypoperfusion, Cerebral Infarction, Stroke

Received: 13 Jun 2018; Accepted: 31 Aug 2018.

Edited by:

Yuan-Pang Wang, Universidade de São Paulo, Brazil

Reviewed by:

Rong Chen, University of Maryland, Baltimore, United States
Bingkun K. Chen, Mayo Clinic, United States  

Copyright: © 2018 Deng, Wang, Sun, Liu, Zhu, Wang, Sui, Shen, Gu, Mo, Ma, Song, Li, Huo, Chen and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Duanduan Chen, Beijing Institute of Technology, School of Mechatronical Engineering, Beijing, 100081, Beijing Municipality, China, duanduan@bit.edu.cn
Prof. Feng Gao, Beijing Tiantan Hospital, Capital Medical University, Department of Interventional Neuroradiology, Beijing, China, gaofengttyy@yeah.net