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Objective To explore the influence of collateral circulation on the cognition of persons with severe unilateral carotid artery stenosis or occlusion using transcranial Doppler (TCD) imaging combined with P300.Methods A total of 185 patients with stenosis or occlusion of the carotid artery were enrolled and randomly divided into a monocollateral group (n=83),a multicollateral group (n=79) and a noncollateral group (n=23).The monocollateral group was further divided into an anterior communicating artery (AcoA) group,an ophthalmic artery (OA)group and a post communicating artery (PcoA) group according to their collateral circulation.All patients and 40 normal controls (NC) were tested using the Montreal cognitive assessment (MoCA) and P300,and the correlation between the MoCA and P300 scores was analyzed.Results Compared with the NC group,all the other three groups had significantly lower average MoCA scores and P300 amplitudes.They also had significantly longer average P300 latency periods.Compared with the multicollateral group,both the monocollateral and noncollateral groups had significantly lower average MoCA scores and P300 amplitudes and longer P300 latencies.Comparing the monocollateral group with the noncoilateral group revealed the same trends.Among the monocollateral patients the average MoCA score of the AcoA group was significantly higher than the PcoA and OA group averages,while their average P300 latency period was significantly shorter and the amplitude significantly greater than the PcoA group's average.Correlation analyses showed that the MoCA score was negatively correlated with the P300 latency,but positively correlated with the P300 amplitude.Conclusions Collateral circulation can protect the cognitive function of patients with unilateral stenosis or occlusion of the internal carotid artery to some extent,with multicollateral circulation being more effective than monocollateral and AcoA circulation superior to both PcoA and OA circulation.The MoCA score is significantly correlated with the latency period of P300 in such cases.
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Objective To investigate the influence of collateral circulation recruitment on cognitive functions in patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery by using TCD.Methods A total of 176 patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery were enrolled and were divided into a single vessel collateral group(n=80,45.5 ％),a multiple vessel collateral group(n=74,42.1％) and a no collateral group(n=22,12.5 ％).In order to study the influence of single vessel collateral circulation on cognitive functions,the single vessel collateral group was further divided into an anterior communicating subgroup(AcoA),a posterior communicating subgroup(PcoA),an ocular artery subgroup(OA),and a normal control subgroup.All patients and 34 normal controls(NC) received MoCA,and scores for the overall assessment and individual domains were analyzed.Results Compared with the control group (26.3± 1.1,4.7 ± 0.5,2.0 ± 0.0,3.6 ± 1.0),the multiple vessel collateral group,the single vessel collateral group and the no collateral group had lower overall scores (24.2 ± 1.7,21.9 ± 2.3,19.0 ± 2.4),lower executive/visuospatial function(3.9 ± 0.7,3.2 ± 0.8,2.4 ± 0.6),lower abstraction (1.7 ± 0.5,1.6±0.5,1.3±0.5),and lower delayed recall(2.9±0.8,1.9±0.8,1.6±0.5)(F=80.52,63.21,12,48.99,all P＜0.05);both collateral groups had lower scores in subtraction and attention (4.6±0.6 vs.5.2±0.7,4.3±0.7 vs.5.2±0.7);the no collateral group had lower scores in orientation(4.7±0.7 vs.5.7±0.5)(P＜0.05).Compared with the multiple vessel collateral group,both the single vessel collateral group and the no collateral group had lower overall scores(21.9±2.3 vs.24.2 ± 1.7,19.0± 2.4 vs.24.2 ± 1.7),executive/visuospatial function (3.2 ± 0.8 vs.3.9 ± 0.7,2.4±0.6 vs.3.9±0.7),subtraction and attention(4.6±0.6 vs.5.1±0.5,4.3±0.7 vs.5.1±0.5) (all P＜ 0.05);the no collateral group had lower scores in abstraction (1.3 ± 0.5 vs.1.7 ± 0.5),delayed recall(1.6 ± 0.5 vs.2.9 ± 0.8) and orientation (4.7 ± 0.7 vs.5.7 ± 0.5) (all P ＜ 0.05).Compared with the single vessel collateral group,the no collateral group had lower overall scores(19.0 ±2.4 vs.21.9±2.3),executive/visuospatial function(2.4±0.6 vs.3.2±0.8)and orientation(4.7± 0.7 vs.5.7 ± 0.6) (all P ＜0.05).In single vessel collateral patients,the AcoA subgroup had higher MoCAscores than the PcoA subgroup(22.9± 1.7 vs.21.2±2.7) (P＜0.05),and the AcoA subgroup had higher scores in delayed recall than the OA subgroup(2.2±0.8 vs.1.7±0.6) (P＜ 0.05).Conclusions Severe unilateral stenosis or unilateral occlusion in the internal carotid artery can result in cognitive impairment,especially in executive/visuospatial function,abstraction,delayed recall,subtraction and attention.However,collateral circulation can protect cognitive function in patients with unilateral internal carotid artery stenosis or occlusion and multiple vessel collateral circulation is more effective than single vessel collateral circulation,and AcoA is more effective than either PcoA or OA,but the difference between PcoA and OA is not significant.
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Objective To investigate the relationship between auditory event-related potentials to an oddball task and age in healthy adults,in order to provide the basis for the clinical diagnosis of age-related cognitive diseases.Methods 90 subjects were examined by auditory event-related potentials to an oddball task,and divided into normal young adults,middle-aged and elderly groups (n =30,each group).We measured the wave latencies and amplitude of P50,N100 and P200 wave recorded at the Cz points,and those of N200 and P300 wave at the Pz point.The correlations of the above indicators with age were analyzed.Results The reaction times were (519.33±33.65) ms in youth group,(521.52±39.81) ms in middle age group and (531.46±43.26) ms in elderly group.There were no statistically differences in reaction times among the 3 groups(F=1.89,P=0.107).Compared with the youth group,P50 amplitudes were increased [(2.03±0.31) μV vs.(1.83±0.23) μV,t=2.17,P＝ 0.032],P300 latencies were prolonged [(343.17 ± 30.70) ms vs.(323.54 ± 24.56) ms,t=2.23,P=0.028],P300 amplitudes were decreased [(13.88±3.15) μV vs.(15.62± 2.12) μV,t=2.35,P＝0.018] in the middlc-aged group.Compared with the middle-aged group,the elderly group showed that P50 amplitudes were increased [(2.39±0.40) μV vs.(2.03±0.31) μV,t =4.73,P=0.000],N200latencies were prolonged [(222.16±29.40) ms vs.(206.04±28.98) ms,t=2.12,P=0.039],P300 latencies were prolonged and amplitudes were decreased [(373.83 ± 45.90)ms vs.(343.17±30.70)ms,t=5.12,P=0.000; (10.68±4.16)μV vs.(13.88±3.15) μV,t=4.95,P=0.000].Other waves had no significant differences in latencies and amplitudes among the three groups (all P＞ 0.05).In all subjects,P50 amplitudes and P300 latencies showed positively correlated with age.The average increments of P50 amplitudes and P300 latencies in normal young adults,middle-aged and elderly groups were 0.008 V/year,0.012 V/year and 0.016 V/year,and 0.917 ms/year,1.148 ms/year and 1.715 ms/year respectively.Conclusions In healthy adults,P50 amplitude and P300 latency of auditory event-related potentials are related with age.P50 amplitude and P300 latency are gradually increased or prolonged along with age,with accelerated changes in the elderly.
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Objective To explore the effects of donepezil on auditory event-related potentials in cases of mild cognitive impairment(MCI).Methods Thirty-four mildly impaired patients were examined using auditory event-related potentials and neuropsychological tests.All patients received 5 mg of donepezil orally each day.The patients were retested with the neuropsychological scales and re-examined for auditory event-related potentials after 3 months of treatment.Results All neuropsychological test scores among the MCI patients had improved significantly after treatment There was no significant change in average Boston naming test scores before and after treatment.PS0 amplitudes had decreased significantly after treatment,but P300 amplitude was elevated and latency significantly shortened compared with before treatment.PS0 amplitude was positively correlated with P300 latency in these MCI patients before treatment,but both P300 latencies and PS0 amplitudes showed a negative correlation with scores on the memory sub-tests.Conclusions These results suggest that donepezil may improve cognitive function among MCI patients,especially memory function.The PS0 and P300 components of auditory event-related potentials are objective and sensitive indicators to evaluate the cognition function of MCI patients,and they also can be used as indicators in assessing the efficacy of donepezil treatment of mild cognitive impairment.