Study on the correlation between subtypes of cerebral small vessel disease, extracranial carotid arteriosclerosis and vascular cognitive impairment

Abstract:

Objective: To study the correlation between subtypes of cerebral small vessel disease (CSVD) and extracranial carotid atherosclerosis and vascular cognitive impairment (VCI). Methods: The demographic and medication history data of 200 stroke-free CSVD patients were collected in the study. Carotid ultrasound was performed and carotid atherosclerosis was assessed using extracranial carotid atherosclerosis score. Brain magnetic resonance imaging (MRI) was performed and the lesions of various subtypes of CSVD were assessed. Montreal cognitive assessment (MoCA) score was used to screen patients with cognitive dysfunction. According to the total score of MoCA<23, the patients were divided into VCI group and non-VCI group. Univariate analysis and multivariate logistic regression were used to screen independent risk factors for VCI in strokefree patients. We also established a model and used the receiver operating characteristic (ROC) curve to assess independent risk factors and calculated the cut-off value, etc. The best cut-off value of the CSVD score among the independent risk factors was used as a baseline to assess the cognitive impairment of the cerebral small vessels, cerebral small vascular cognitive burden score was calculated and was evaluated by the ROC curve. Results: Logistic regression analysis showed that the sum of lacunar infarction (LI) +lacune, Fazekas score and global cortical atrophy (GCA) score were positively correlated with VCI (P<0.05), while there was no significant correlation between extracranial carotid arteriosclerosis score and VCI (P>0.05). The area under the curve (AUC) of the established prediction model and the AUC of the cerebral small vascular cognitive burden score were>0.7, respectively. Conclusion: Some subtypes of CSVD are significantly correlated with VCI, while extracranial mild carotid atherosclerosis has no obvious correlation with VCI. The model can be established by CSVD or the cerebral small vascular cognitive burden score which is more convenient in clinic can be used to screen the small vascular cognitive impairment in strokefree patients.