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Association Between Cerebral Hypoperfusion and Cognitive Impairment in Patients With Chronic Vertebra-Basilar

Yiming Deng1,2,3, Luyao Wang4, Xuan Sun1,2,3

  • 1Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Frontiers in Psychiatry
|October 16, 2018
PubMed

Insights

Chronic vertebra-basilar (VB) stenosis leads to cognitive impairment due to reduced cerebral blood flow. Reduced perfusion in the posterior circulation significantly impacts memory and executive functions.

Area of Science:

  • Neurology
  • Neuroimaging
  • Cognitive Neuroscience

Background:

  • Chronic vertebra-basilar (VB) stenosis is a significant risk factor for cerebrovascular events.
  • Cognitive impairment is a common complication in patients with VB stenosis.
  • Cerebral haemodynamic changes play a crucial role in cognitive function.

Purpose of the Study:

  • To investigate the association between cognitive impairment and cerebral haemodynamic changes in patients with severe VB stenosis.
  • To identify specific cognitive deficits related to different levels of cerebral perfusion.
  • To determine independent risk factors for cognitive impairment in this patient population.

Main Methods:

  • A cohort of 96 patients with severe posterior circulation VB stenosis was divided into three groups based on computed tomography perfusion (CTP) status: normal, compensated, and decompensated.
  • Cognitive function was assessed using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
  • Multiple regression analyses were performed to identify independent risk factors for cognitive impairment.

Main Results:

  • Patients in the CTP decompensated group showed significantly lower MMSE and FAB scores compared to the CTP normal and compensated groups.
  • RBANS scores, including immediate memory, visual acuity, and delayed memory, were significantly lower in both CTP compensated and decompensated groups compared to the CTP normal group.
  • CTP compensation, CTP decompensation, severe VB tandem stenosis, and multiple infarctions were identified as independent risk factors for cognitive impairment.

Conclusions:

  • Low cerebral perfusion resulting from severe VB stenosis is associated with extensive cognitive impairments.
  • Specific cognitive domains affected include immediate memory, visual span, and delayed memory.
  • Cerebral haemodynamic status is a critical determinant of cognitive function in patients with VB stenosis.

Keywords:
cerebral hypoperfusioncerebral infarctioncognitive impairmentstrokevertebra-basilar stenosis

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