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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(06): 524-532
DOI: 10.1055/s-0043-1768663
Original Article

Associations between cognitive impairment and computed tomography perfusion in different lobes in acute stroke of the anterior circulation

Associações entre déficit cognitivo e perfusão de tomografia computadorizada em diferentes lobos no AVC agudo da circulação anterior
Mengna Chu 
1   Anhui Medical University, Second Affiliated Hospital, Department of Neurology, Hefei, China.
,
Bin Dong 
2   Anhui Medical University, Third Affiliated Hospital, Department of Neurology, Hefei, China.
,
Chao Huang 
2   Anhui Medical University, Third Affiliated Hospital, Department of Neurology, Hefei, China.
› Author Affiliations Support The present work was supported by the Applied Medical Research Project of Hefei Municipal Health and Family Planning Commission in 2017 (hwk2017ZD007) and by the Scientific Research Fund of Anhui Medical University in 2020 (2020xkj237).
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Abstract

Background Cognitive impairment (CI) during the acute phase of stroke should not be ignored. The present study analyzed the relationship between computed tomography perfusion (CTP) in different lobes and CI during the acute phase of stroke in patients with cerebral infarction.

Methods The present study included 125 subjects: 96 in the acute phase of stroke and 29 elderly healthy subjects as a control group. The Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive status of the two groups. The CTP scans include four parameters: cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and mean transit time (MTT).

Results The MoCA scores for naming, language and delayed recall significantly decreased only in patients with left cerebral infarctions. The MTT of the left vessels in the occipital lobe and the CBF of the right vessels in the frontal lobe were negatively related to the MoCA scores of patients with left infarction. The CBV of the left vessels in the frontal lobe and the CBF of left vessels in the parietal lobe were positively linked to the MoCA scores of patients with left infarction. The CBF of the right vessels in the temporal lobe was positively related to the MoCA scores of patients with right infarction. Finally, the CBF of the left vessels in the temporal lobe was inversely correlated with the MoCA scores of patients with right infarctions.

Conclusion During the acute phase of stroke, CTP was closely associated with CI. Changed CTP could be a potential neuroimaging biomarker to predict CI during the acute phase of stroke.

Resumo

Antecedentes O comprometimento cognitivo (CC) durante a fase aguda do acidente vascular cerebral (AVC) não deve ser ignorado. O presente estudo analisou a relação entre perfusão por tomografia computadorizada (PTC) em diferentes lobos e CC durante a fase aguda do AVC em pacientes com infarto cerebral.

Métodos O presente estudo incluiu 125 indivíduos: 96 na fase aguda do AVC e 29 idosos saudáveis como grupo controle. O Montreal Cognitive Assessment (MoCA) foi usado para avaliar o estado cognitivo dos dois grupos. Os exames de PCT incluem quatro parâmetros: fluxo sanguíneo cerebral (FSC), volume sanguíneo cerebral (VSC), tempo até o pico (TAP) e tempo médio de trânsito (TMT).

Resultados Os escores do MoCA para nomeação, linguagem e recordação tardia diminuíram significativamente apenas em pacientes com infarto cerebral esquerdo. O TMT dos vasos esquerdos no lobo occipital e o FSC dos vasos direitos no lobo frontal foram negativamente relacionados aos escores MoCA de pacientes com infarto esquerdo. A VSC dos vasos esquerdos em o lobo frontal e o FSC dos vasos esquerdos no lobo parietal foram positivamente ligados aos escores MoCA de pacientes com infarto esquerdo. O FSC dos vasos direitos no lobo temporal foi positivamente relacionado com os escores MoCA de pacientes com infarto direito. Finalmente, o FSC dos vasos esquerdos no lobo temporal foi inversamente correlacionado com os escores MoCA de pacientes com infartos direitos.

Conclusão Durante a fase aguda do AVC, a PCT esteve intimamente associada ao CC. O PCT alterado pode ser um potencial biomarcador de neuroimagem para prever CC durante a fase aguda do AVC.

Keywords

Cognitive Dysfunction - Stroke - Cerebral Circulation

Palavras-chave

Disfunção Cognitiva - Acidente Vascular Cerebral - Circulação Cerebral

Authors' Contributions

MC: conceptualization, data curation, formal analysis, project administration, resources, software, writing of original draft, and writing – review and editing; BD: investigation, methodology, supervision, validation, visualization, and writing – review and editing; CH: data curation and resources.




Publication History

Received: 06 July 2022

Accepted: 23 January 2023

Article published online:
28 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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