Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials
We investigated the neuropsychological characteristics, cranial MRI, and P300 ERPs in patients suffering from vascular cognitive impairment with no dementia (VCIND). A study was performed on 68 cases of VCIND after stroke. The cranial MRI patterns and P300 waves of the patients were compared with...
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Інститут фізіології ім. О.О. Богомольця НАН України
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irk-123456789-1481252019-02-18T01:24:20Z Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials Jiang, B. Yao, G. Yao, C. Zhang, Yu. Ge, J. Qiu, E. We investigated the neuropsychological characteristics, cranial MRI, and P300 ERPs in patients suffering from vascular cognitive impairment with no dementia (VCIND). A study was performed on 68 cases of VCIND after stroke. The cranial MRI patterns and P300 waves of the patients were compared with those of 56 stroke patients without cognitive impairment and 52 healthy subjects. The MoCA (Montreal Cognitive Assessment) was also used to assess their mental status. The proportion of patients with frontotemporal lesions, multiple lesions, and leukoaraiosis (LA) in the VCIND group was greater than that in the stroke group. The cognitive impairment in patients with the former deficiencies was more significant. The MoCA scores in the VCIND group were significantly lower, and the P300 latency was significantly longer, as compared with other two groups. The P300 latency inversely correlated with the MoCA score. Patients with frontotemporal lesions, multiple lesions, and LA are susceptible to cognitive impairment. The MoCA score and the P300 test are helpful for the early diagnosis of VCIND. Ми досліджували нейропсихологічні характеристики, дані магніторезонансного дослідження мозку (MRI) та пов’язані з подією ЕЕГ-потенціали P300 у пацієнтів зі зумовленим судинними захворюваннями ураженням когнітивних функцій при відсутності деменції (VCIND). Дослідження було проведено у 68 випадках VCIND, котре розвивалося після інсульту. Дані MRI та характеристики P300 у групі VCIND порівнювали з такими у двох інших групах (у 56 пацієнтів після інсульту без розладів когнітивних функцій та у 52 здорових суб’єктів). Шкалу MoCA (Монреальська когнітивна оцінка) використовували для оцінки інтелектуального статусу обстежених. Відносна кількість випадків фронтотемпоральних уражень, множинних уражень та лейкоарайозу (ЛА) у групі VCIND була більшою, ніж у групі пацієнтів з неускладненим інсультом. Розлади когнітивних функцій у пацієнтів із зазначеними вище ураженнями були більш істотними. Оцінки згідно з MoCA в групі VCIND були достовірно нижчими, а латентний період P300 був істотно тривалішим, ніж у двох інших групах. Пацієнти з фронтотемпоральними та множинними ураженнями й ЛА особливо схильні до когнітивних розладів. Використання оцінок за MoCA та відведення потенціалу Р300 є вельми доцільними в аспекті ранньої діагностики VCIND. 2013 Article Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials / B. Jiang, G. Yao, C. Yao, Yu. Zhang, J. Ge, E. Qiu // Нейрофизиология. — 2013. — Т. 45, № 4. — С. 362-368. — Бібліогр.: 19 назв. — англ. 0028-2561 http://dspace.nbuv.gov.ua/handle/123456789/148125 316.276:543.429.2 en Нейрофизиология Інститут фізіології ім. О.О. Богомольця НАН України |
| institution |
Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| collection |
DSpace DC |
| language |
English |
| description |
We investigated the neuropsychological characteristics, cranial MRI, and P300 ERPs in
patients suffering from vascular cognitive impairment with no dementia (VCIND). A study
was performed on 68 cases of VCIND after stroke. The cranial MRI patterns and P300 waves
of the patients were compared with those of 56 stroke patients without cognitive impairment
and 52 healthy subjects. The MoCA (Montreal Cognitive Assessment) was also used to assess
their mental status. The proportion of patients with frontotemporal lesions, multiple lesions,
and leukoaraiosis (LA) in the VCIND group was greater than that in the stroke group. The
cognitive impairment in patients with the former deficiencies was more significant. The MoCA
scores in the VCIND group were significantly lower, and the P300 latency was significantly
longer, as compared with other two groups. The P300 latency inversely correlated with the
MoCA score. Patients with frontotemporal lesions, multiple lesions, and LA are susceptible to
cognitive impairment. The MoCA score and the P300 test are helpful for the early diagnosis
of VCIND. |
| format |
Article |
| author |
Jiang, B. Yao, G. Yao, C. Zhang, Yu. Ge, J. Qiu, E. |
| spellingShingle |
Jiang, B. Yao, G. Yao, C. Zhang, Yu. Ge, J. Qiu, E. Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials Нейрофизиология |
| author_facet |
Jiang, B. Yao, G. Yao, C. Zhang, Yu. Ge, J. Qiu, E. |
| author_sort |
Jiang, B. |
| title |
Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials |
| title_short |
Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials |
| title_full |
Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials |
| title_fullStr |
Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials |
| title_full_unstemmed |
Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials |
| title_sort |
vascular cognitive impairment with no dementia: neuropsychology, brain imaging, and event-related potentials |
| publisher |
Інститут фізіології ім. О.О. Богомольця НАН України |
| publishDate |
2013 |
| url |
http://dspace.nbuv.gov.ua/handle/123456789/148125 |
| citation_txt |
Vascular Cognitive Impairment with NO Dementia: Neuropsychology, Brain Imaging, and Event-Related Potentials / B. Jiang, G. Yao, C. Yao, Yu. Zhang, J. Ge, E. Qiu // Нейрофизиология. — 2013. — Т. 45, № 4. — С. 362-368. — Бібліогр.: 19 назв. — англ. |
| series |
Нейрофизиология |
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| first_indexed |
2025-07-12T18:23:51Z |
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2025-07-12T18:23:51Z |
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| fulltext |
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2013.—T. 45, № 4362
UDC 316.276:543.429.2
B. JIANG1, G. YAO1, C. YAO1, Yu. ZHANG1,
J. GE1, and E. QIU1
VASCULAR COGNITIVE IMPAIRMENT WITH NO DEMENTIA:
NEUROPSYCHOLOGY, BRAIN IMAGING, AND EVENT-RELATED POTENTIALS
Received November, 22, 2012.
We investigated the neuropsychological characteristics, cranial MRI, and P300 ERPs in
patients suffering from vascular cognitive impairment with no dementia (VCIND). A study
was performed on 68 cases of VCIND after stroke. The cranial MRI patterns and P300 waves
of the patients were compared with those of 56 stroke patients without cognitive impairment
and 52 healthy subjects. The MoCA (Montreal Cognitive Assessment) was also used to assess
their mental status. The proportion of patients with frontotemporal lesions, multiple lesions,
and leukoaraiosis (LA) in the VCIND group was greater than that in the stroke group. The
cognitive impairment in patients with the former deficiencies was more significant. The MoCA
scores in the VCIND group were significantly lower, and the P300 latency was significantly
longer, as compared with other two groups. The P300 latency inversely correlated with the
MoCA score. Patients with frontotemporal lesions, multiple lesions, and LA are susceptible to
cognitive impairment. The MoCA score and the P300 test are helpful for the early diagnosis
of VCIND.
Keywords: cognitive impairment, cerebrovascular disorders, MRI, neuropsychology,
event-related potentials, P300.
1 Department of Neurology, the First Hospital Affiliated to the Chinese PLA
General Hospital, Beijing, China.
Correspondence should be addressed to Bo Jiang
(e-mail: bojiangcn@126.com).
INTRODUCTION
Vascular cognitive impairment (VCI) describes
a broad class of syndromes, from mild cognitive
disorders to dementia caused by cerebrovascular risk
factors and obvious or not obvious cerebrovascular
diseases. The latter cover the whole process of VCI,
from a mild to a severe degree, and include vascular
cognitive impairment with no dementia (VCIND),
vascular dementia, mixed dementia, and other types
[1]. VCIND refers to the early or mild cognitive
impairment caused by cerebrovascular damage [2].
VCIND is a hidden disease, and the degree of cognitive
impairment usually does not reach the diagnostic
criteria for clear dementia [1]. The incidence rate of
VCIND is reportedly about 26.9% at 3 months after a
stroke [3]. Early diagnosis and adequate intervention
for VCIND patients can improve the prognosis;
otherwise, VCIND will progress into dementia [4].
Studies on VCI have mainly been focused on vascular
dementia; thus, research on VCIND, which has the
best clinical intervention result, remains relatively
limited. The pathogenic factors of VCIND have
not been fully determined, and methods for early
diagnosis are lacking. Our study aimed to observe the
neuropsychological, imaging, and P300 characteristics
of VCIND patients to improve the early diagnostic
rate and provide a basis for early intervention.
METHODS
Subjects. A total of 68 VCIND cases (42 men and
26 women, inpatients and outpatients) who had a
stroke were included in the study. The patients,
44- to 78-year-old, with a mean age of 64 ± 2.4 years,
were recruited between 2006 and 2011. The diagnostic
criteria for VCIND (based on the criteria by Rockwood
et al. [2]) are as follows: presence of a cerebrovascular
Article
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2013.—T. 45, № 4 363
disease, neuropsychological evaluation (including
evidence of cognitive impairment), cognitive
impairment occurring within 3 months after stroke, a
causal relationship between cerebrovascular disease
and cognitive impairment, excluding other diseases,
and Hanchinski ischemic score ≥7 not meeting the
dementia diagnosis criteria. The exclusion criteria
included Alzheimer’s disease and the presence of other
conditions, such as mental retardation, depression,
mental disease, and aphasia that affects the Montreal
Cognitive Assessment (MoCA) score.
Fifty-six (30 men and 26 women) patients with
stroke (outpatients and inpatients) were also included
as subjects. These subjects were 38- to 76-year-old,
with an average age of 63 ± 2.5 years. Stroke was
diagnosed in accordance with the diagnostic criteria
[5] amended by the European Stroke Initiative and
confirmed by cranial MRI, with the scale assessment.
A clinical and cognitive function test was performed
for patients without cognitive impairment.
Fifty-two control cases (32 men and 20 women),
healthy individuals that checked into the hospital
at the same time, were also included. The members
of this group were from 35 to 72 year old, with an
average age of 63 ± 3.57 years. They had no obvious
lesions and no cognitive impairment under the clinical
and cognitive function test.
Cranial MRI. The MRI imaging studies were
carried out on a Novus 1.5 T superconducting MRI
(Siemens, Germany). The patients were subjected to an
axial T1WI, T2WI, FLAIR, and DWI, and the location
of the stroke lesions, their number, and the presence
of leukoaraiosis (LA) were observed. Leukoaraiosis is
defined as sites of periventricular or deep white matter
with a high signal intensity and no clear edges under
T2WI and FLAIR; DWI does not show obviously
high signals, and TIWI shows equal or slightly
lower signals. Leukoaraiosis excludes the decreased
white matter density caused by multiple sclerosis,
intracranial infection, radiation encephalopathy,
anthracemia, hypotension, anemia, demyelinating
disease, adrenoleukodystrophy, and other diseases.
Cognitive Function Check. The MoCA assessment
scale was used to evaluate the cognitive function
of the patients. The MoCA has 11 items assessing
eight cognitive domains. These domains include
visuospatial/executive abilities, naming, memory,
attention, language, abstraction, delayed recall, and
calculation ability, with a total possible score of 30.
One more score is added for subjects with less than
12 years of education. The higher the score, the better
is the cognitive function of the subject; MoCA scores
below 26 indicate cognitive impairment.
P300 Wave. Recording of this ERP was performed
in all patients within 48 h after they were enrolled
in the study. A Britain Oxford’s multimedia
EMG/EP system was adopted. In a quiet shielded
room, the subjects were asked to lie supine, remain
calm, and concentrate. According to the international
10/20 EEG system, a recording electrode was placed
along the central line, a reference electrode was
placed on the right earlobe, and a ground electrode
was on the forehead. The electrode impedance was
maintained below 5 kW, and the analysis time was
600 msec. Short sound stimulation was used in the
experiment. The probability for nontarget stimulation
(frequency 1,000 Hz) showed regularly was 80% at
a signal strength of 80 dB. The probability for target
stimulation (frequency 4,000 Hz) showed randomly
and alternated with nontarget stimulation was 20% at a
signal strength of 90 dB. The subjects were instructed
to press a key for target stimulation, and the instrument
automatically recorded the response time. The test was
repeated twice, and the means were calculated.
Statistical Analysis. SPSS 16.0 statistical software
was used to analyze the data. The measured data were
expressed as means ± s.e.m. The ANOVA and t-test
were performed. The counting data were indicated by
percentage, and the c2 test was performed. Pearson’s
correlation analysis was also used to analyze the data.
Differences with P < 0.05 were considered statistically
significant.
RESULTS
Comparison of General Characteristics. The three
examined groups did not differ from each other in
terms of gender composition and cultural degree.
The proportion of patients with diabetes mellitus and
smoking history in the VCIND group was higher than
those in other two groups. The proportion of patients
with hypertension and hyperlipidemia in the VCIND
group was higher than that in the control group
(Table 1).
Cognitive Function. The total MoCA scores of the
VCIND patients were significantly lower than those of
other two groups (P < 0.01). The total MoCA scores
of the stroke group did not significantly differ from
those of the control group. The MoCA subitems in
the VCIND group were lower than those in the stroke
group, whereas the MoCA scores of the control group
Article
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2013.—T. 45, № 4364
TABLE 1. Comparison of Basic Clinical Data among Three Groups
Т а б л и ц я 1. Порівняння основних клінічних даних у пацієнтів трьох груп
Group Number
of cases
Gender Educational level Focal areas Lesion number
Hyper-
tension
Diabe-
tes
Hyper-
lipid-
emia
Smok-
ing
history men women uni-
versity
senior
high
school
junior
high
school
fronto-
temporal
lobar
other multiple single
VCIND 68 42(61.76) 26(38.24) 9(13.24) 51(75.00) 8(11.76) 30(44.12) 38(55.88) 43(63.24) 25(36.76) 33(48.53) 38(55.88) 30(44.12) 37(54.41)
Stroke 56 30(53.57) 26(46.43) 6(10.71) 45(80.36) 5(8.93) 11(19.64) 45(80.36) 22(39.29) 34(60.71) 24(42.86) 16(28.57) 22(39.29) 13(23.21)
Control 52 32(61.54) 20(38.46) 7(13.46) 40(76.92) 5(9.62) 13(25.00) 12(23.08) 9(17.31) 12(23.08)
Comparison
among groups
(χ2) 1.76 0.96 8.31** 7.06** 10.56** 15.84** 8.80* 19.36**
Footnotes. Case and percentage (in brackets) are shown. **P < 0.01 and *P < 0.05.
differed significantly (P < 0.05, Table 2) in terms of
memory, visuospatial/executive abilities, attention,
and abstract ability. However, the MoCA subitem
scores in the stroke group did not differ significantly
from those in the control group.
Number of Lesions, Lesion Position, LA, and
Cognitive Function of VCIND Patients. The
proportion of patients with frontotemporal lesions in
the VCIND group was 55.9%, i.e., much higher than
that in the stroke group (19.6%, c2 = 8.31, P < 0.01).
The proportion of the patients with frequently
occurring lesions was 63.2%, also higher than that
in the stroke group (39.3%, c2 = 7.06, P < 0.01).
The proportion of patients with LA in the VCIND
group was 58.8%, also significantly higher than that
in the stroke group (30.4%, c2 = 10.02, P < 0.01).
The proportion of the lesions in the left cerebral
hemisphere in the VCIND group was 67.6%, which
did not significantly differ from that in the stroke
group (57.1%, c2 = 1.45, P > 0.05). The position of
lesions, the number of lesions, and the presence of LA
in the VCIND group directly affected the degree of
impairment of the cognitive function. More lesions
corresponded to lower MoCA scores and greater
degrees of impairment of the cognitive function for
patients with frontotemporal lesions and patients
with LA (Table 3).
P300 Characteristics. The P300 latencies for
patients of the VCIND group were significantly
longer than those in the stroke and control groups
TABLE 2. Comparison of the MoCA Rating Scale among Three Groups (Score)
Т а б л и ц я 2. Порівняння оцінок за рейтинговою шкалою МоСа у пацієнтів трьох груп
Item VCIND
(68 cases)
Stroke
(56 cases)
Control
(52 cases)
Memory ability 3.71 ± 0.77** 4.67 ± 0.68 4.70 ± 0.47
Language fluency 2.71 ± 0.47 2.71 ± 0.46 2.75 ± 0.44
Vision space/executive ability 2.59 ± 0.87** 4.67 ± 0.48 4.70 ± 0.46
Naming ability 2.71 ± 0.47 2.95 ± 0.22 2.75 ± 0.44
Attention and computing ability 4.06 ± 0.90** 5.48 ± 0.51 5.55 ± 0.60
Abstract epitome ability 1.40 ± 0.51* 1.71 ± 0.46 1.80 ± 0.41
Orientation ability 5.24 ± 0.56 5.57 ± 0.51 5.45 ± 0.60
Total 22.18 ± 1.62** 27.76 ± 1.14 27.70 ± 1.08
Footnotes. Means ± s.e.m. are shown. One and two asterisks show cases of significant difference vs two other groups with P < 0.05 and
P < 0.01, respectively.
Article
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2013.—T. 45, № 4 365
(P < 0.01). No significant difference in the P300
latency was observed between the stroke group and the
control group (P > 0.05). The P300 amplitude did not
show significant differences among the three groups
(P > 0.05, Table 4).
Correlation between the P300 Parameters and
MoCA. Correlation analysis was carried out among
the P300 latency, amplitude, and MoCA score of the
VCIND group. The MoCA score inversely correlated
with the P300 latency (r = –0.798, P = 0.001), but did
not correlate significantly with the amplitude of this
wave (r = 0.057, P = 0.846).
DISCUSSION
Searching for the related pathogenic factors, simple
and effective test methods, and methods for early
detection of mild cognitive function impairment is
necessary for adequate treating of VCIND patients.
Many s tudies demonst ra ted tha t vascular
cognitive impairment is related to the risk factors of
cerebrovascular diseases, the characteristics of stroke,
and the characteristics of the patient. At present,
diabetes, hypertension, heart diseases, and other
disorders are believed to be related to the occurrence
of cognitive impairment. However, compared to other
factors, diabetes is more closely related to vascular
cognitive impairment [6] because it causes cerebral
arteriosclerosis, microcirculation disturbance, and
small-vessel disease. Finally, it leads to neuronal
degeneration, which causes cognitive function
impairment. In our study, the incidence of diabetes
mellitus was clearly higher in the VCIND group
TABLE 3. Numbers of Lesions, Position of Lesions, Leukoaraiosis, and Cognitive Function in VCIND Patients
Т а б л и ц я 3. Кількість уражень мозку, їх локалізація, кількість випадків лейкоарайозу та оцінка когнітивних функцій у
пацієнтів з VCIND
Group
Number of lesions Position of lesions Leukoaraiosis
multiple single frontotemporal lobar other yes no
Number of
cases
43 25 30 38 40 28
MoCA 22.00 ± 1.83 23.70 ± 1.83 21.90 ± 1.37 23.60 ± 0.84 21.80 ± 1.03 23.30 ± 0.67
T value 2.55 3.34 3.85
P value 0.02 0.004 0.001
Footnote. Means ± s.e.m. are shown.
TABLE 4. Comparison of Latency and Amplitude of the Central-Line P300 between the Groups
Т а б л и ц я 4. Міжгрупове порівняння латентних періодів та амплітуд потенціалу Р300 (відведення по центральній лінії) у
пацієнтів і контрольних суб’єктів
Group Number of
cases P300 latency, msec P300 amplitude, μV
VCIND 68 379.12±25.68** 4.04±0.75
Stroke 56 325.10±13.52 4.25±0.74
Control 52 324.27±11.74 3.96±0.49
F value 144.66 2.02
P value 0.000 0.136
Footnotes. Means ±s.e.m. are shown. Two asterisks show significant difference in comparison of the VCIND group vs the other two groups
with P < 0.01.
Article
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2013.—T. 45, № 4366
than in other groups, which indicates that diabetes
may be more closely related to cognitive function
impairment. Smoking is an independent risk factor for
cerebrovascular diseases. The proportion of patients
who smoke in the VCIND group was evidently higher
than that in the stroke group, which is in accordance
with the related reports that smoking increases the
risk of stroke. Smoking also positively correlated with
cognitive function impairment [7].
A few studies reported that the number and position
of cerebral infarcts correlate with the degree of
cognitive impairment. Straaten et al. [8] found that
a history of stroke recurrence and multiple strokes
are important causes for sharp declines in cognitive
function. Our findings indicate that the VCIND group
had more lesions compared with the stroke group.
Within the VCIND group, the patients with multiple
lesions had lower MoCA scores than patients with
single lesions. Considering that the number of lesions
is related to the level of cognitive function, it might
also be related to the cumulative brain damage caused
by multiple lesions and the influence of disorders in
the frontal subcortical loop. Some researchers reported
that lesions in the left cerebral hemisphere, forebrain,
and frontal lobe might play more important roles
in the occurrence of cognitive impairment [9]. We
found that the proportion of frontotemporal lesions in
the VCIND group was higher than that in the stroke
group. Meanwhile, the patients in the VCIND group
with frontotemporal lesions had lower MoCA scores
than patients with lesions at other locations. This
agrees with the statement that the frontotemporal
lobe is more closely related to cognitive functions.
The proportion of left cerebral hemisphere lesions did
not differ significantly between the two groups. This
observation contrasts with the results of the mentioned
report; however, the discrepancy may be related to the
fewer number of cases.
Leukoaraiosis is a term used in imaging diagnosis
coined by Hachinski in 1987 [10] to describe a group
of diseases caused by multiple pathogenic factors
that lead to nonspecific changes in the cerebral
white matter. At present, LA is considered a part of
the human aging process that can lead to cognitive
impairment [11]. The specific mechanism and the
pathogenic changes in the periventricular white
matter affect three limbic loops, the Papez circuit, the
Livingston circuit, and the defensive circuit, which
are related to memory, emotion, behavior, and other
intellectual abilities [12]. The incidence of LA in the
VCIND group was obviously higher than that in the
stroke group. In addition, the patients with LA in the
VCIND group clearly showed signs of decline in the
cognitive function, which indicates that LA patients
are susceptible to impaired cognitive function.
Cognitive function tests play an important role in
diagnosing VCI at an early stage. Nasreddine et al. [13]
formulated the MoCA scale basing on their clinical
experience, with reference to the cognitive project
settings and scoring criteria of the mini-mental state
examination. Lee et al. [14] indicated that the MoCA
scale provides comparatively high sensitivity and
specificity for mild cognitive function impairment. We
found that, compared with the stroke control groups,
the VCIND patients clearly had greater cognitive
function impairment, and their total MoCA score was
lower than that in other two groups. The subitems
mainly show impairment in memory, visuospatial/
executive functions, attention, calculation, and
abstract ability. The above-mentioned study indicated
that MoCA is applicable for VCI screening, which
coincides with our current results.
The P300 ERP is a forward electrotropic change
developing within about 300 msec after target
stimulation. All kinds of sensory modes can induce
the endogenous P300 component. The effects of
physical stimulation parameters on this wave are
minimal, but the P300 characteristics are closely
related to advanced psychological activities and
cognitive processing in the human brain. The P300
reflects multilevel psychological activities, such as
memory, perception, understanding, judgment, and
emotions; recording of this potential is widely applied
in cognitive function research [15]. The P300 latency
reveals the evaluation of the stimulation during
cognitive activities, and it indicates the information
processing rate. Its amplitude indicates the degree
of mobilization of effective resources when the
brain processes information, and it also indicates
the excitability of the brain [16]. Our results and
findings of other authors indicate that the P300 latency
reflects, to some extent, other aspects of the functional
status of the brain, including such characteristics as
sensation, attention, memory, information coding,
cognitive integration rate, and other activities [17].
The amplitudes of the two P300 components did not
differ significantly from each other in our study, which
was probably related to the mildness of the cognitive
function impairment in the VCIND patients and also
to large individual differences. Meanwhile, the P300
latency in the VCIND group was significantly longer
compared with that in the control group, which may
Article
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2013.—T. 45, № 4 367
be indicative of the rather high sensitivity of the P300
latency. The latter parameter of P300 in the VCIND
group showed abnormalities when cognitive function
was mildly impaired. Braverman et al. [18] found that
a longer P300 latency could be used to predict early
cognitive decline, which coincides with our current
results. Bennys et al. [19] reported that the P300
latency is longer among patients with mild cognitive
impairment, and it inversely correlates with the MMSE
score. Correlation analysis in our study showed that
the P300 latency negatively correlates with the MoCA
score. This result confirms that prolonged P300
latencies objectively reflect mild cognitive function
impairment, and this phenomenon cannot be used to
determine the cognitive function impairment related to
the impaired neurological function after stroke.
In conclusion, stroke patients with frontotemporal
lesions and multiple lesions and also patients with
LA are susceptible to cognitive impairment. VCIND
patients have obvious abnormalities in neurological
characteristics and P300 latencies. The cognitive
function impairment in these patients can be detected
earlier by combining neurological tests with the P300
test, which will facilitate timely intervention and
improve prognosis.
Considering that the studied subjects were mostly
elderly persons, even small numbers of cases qualify
for the study. The results of the study are also
dependent on the sensitivity of the cognitive function
determination scale. The relatively small number of
subjects limits the applicability of the results to VCIND
patients, which should be improved by increasing the
sampling size and other methods in future studies.
This study was carried out in accordance with the Declaration
of Helsinki and with approval from the Ethics Committee of The
First Hospital Affiliated to the Chinese PLA General Hospital.
Written informed consent was obtained from all participants.
The authors, B. Jiang, G. Yao, C. Yao, Yu. Zhang, J. Ge, and
E. Qiu, confirm that they have no conflict of interests.
Бо Джіан1, Гуоєн Яо1, Куншан Яо1, Юнян Жан1,
Джунлін Ге1, Енчао К’ю1
РОЗЛАДИ КОГНІТИВНИХ ФУНКЦІЙ ПРИ СУДИН-
НИХ ЗАХВОРЮВАННЯХ З ВІДСУТНІСТЮ ДЕМЕНЦІЇ:
НЕЙРОПСИХОЛОГІЧНІ ХАРАКТЕРИСТИКИ, ДАНІ
МАГНІТОРЕЗОНАНСНОГО ДОСЛІДЖЕННЯ ТА
ПОВ’ЯЗАНІ З ПОДІЄЮ ЕЕГ-ПОТЕНЦІАЛИ
1 Перший шпиталь при Центральній лікарні PLA, Пекін
(Китай).
Р е з ю м е
Ми досліджували нейропсихологічні характеристики, дані
магніторезонансного дослідження мозку (MRI) та пов’язані
з подією ЕЕГ-потенціали P300 у пацієнтів зі зумовленим су-
динними захворюваннями ураженням когнітивних функцій
при відсутності деменції (VCIND). Дослідження було прове-
дено у 68 випадках VCIND, котре розвивалося після інсуль-
ту. Дані MRI та характеристики P300 у групі VCIND порів-
нювали з такими у двох інших групах (у 56 пацієнтів після
інсульту без розладів когнітивних функцій та у 52 здорових
суб’єктів). Шкалу MoCA (Монреальська когнітивна оцінка)
використовували для оцінки інтелектуального статусу об-
стежених. Відносна кількість випадків фронтотемпоральних
уражень, множинних уражень та лейкоарайозу (ЛА) у групі
VCIND була більшою, ніж у групі пацієнтів з неускладне-
ним інсультом. Розлади когнітивних функцій у пацієнтів із
зазначеними вище ураженнями були більш істотними. Оцін-
ки згідно з MoCA в групі VCIND були достовірно нижчи-
ми, а латентний період P300 був істотно тривалішим, ніж
у двох інших групах. Пацієнти з фронтотемпоральними та
множинними ураженнями й ЛА особливо схильні до когні-
тивних розладів. Використання оцінок за MoCA та відведен-
ня потенціалу Р300 є вельми доцільними в аспекті ранньої
діагностики VCIND.
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