Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Aug 19, 2024; 14(8): 1190-1198
Published online Aug 19, 2024. doi: 10.5498/wjp.v14.i8.1190
Effect of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction
Fei-Fei Liang, Xiao-Xia Liu, Jiang-Hong Liu, Yang Gao, Jian-Guo Dai, Zi-Hui Sun
Fei-Fei Liang, Xiao-Xia Liu, Jiang-Hong Liu, Department of Geriatrics, Zhangjiakou First Hospital in Hebei Province, Zhangjiakou 075000, Hebei Province, China
Yang Gao, The Fourth Ward, Zhangjiakou Infectious Disease Hospital, Zhangjiakou 075000, Hebei Province, China
Jian-Guo Dai, Department of Hepatobiliary and Pancreatic Surgery, Zhangjiakou First Hospital in Hebei Province, Zhangjiakou 075000, Hebei Province, China
Zi-Hui Sun, Department of General Medicine, Zhangjiakou First Hospital in Hebei Province, Zhangjiakou 075000, Hebei Province, China
Co-first authors: Fei-Fei Liang and Xiao-Xia Liu.
Author contributions: Liang FF and Liu XX designed the research study and as such are considered as co-first authors; Liu JH and Gao Y performed the research; Liang FF, Liu XX and Dai JG collected and analyzed the data; Dai JG and Sun ZH were involved in drafting the manuscript; All authors were involved in critically revising the manuscript for important intellectual content, gave final approval of the version to be published, participated sufficiently in the work to take public responsibility for appropriate portions of the content, and agreed to be accountable for all aspects of the work in ensuring that questions related to its accuracy or integrity.
Supported by Zhangjiakou City Science and Technology Bureau Municipal Science and Technology Plan Project, No. 2121136D.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of Zhangjiakou First Hospital.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author 18830806530@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Hui Sun, MM, Professor, Department of General Medicine, Zhangjiakou First Hospital in Hebei Province, No. 6 Baisi Lane, Xinhua Front Street, Qiaoxi District, Zhangjiakou 075000, Hebei Province, China. 18830806530@163.com
Received: May 21, 2024
Revised: July 3, 2024
Accepted: July 12, 2024
Published online: August 19, 2024
Processing time: 82 Days and 19 Hours
Abstract
BACKGROUND

The aging of the population has become increasingly obvious in recent years, and the incidence of cerebral infarction has shown an increasing trend annually, with high death and disability rates.

AIM

To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.

METHODS

Between January 2020 and December 2023, we treated 98 cases of elderly acute insula, patients with cerebral infarction in the cerebral infarction acute phase (3-4 weeks) and for the course of 6 months in Montreal Cognitive Assessment Scale (MoCA) for screening of cognition. Notably, 58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group, respectively. In patients with cerebral infarction, magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions, the relationship between the parts of the infarction volume, and analysis of acute insula cognitive disorder in elderly patients with cerebral infarction and the relationship between the two.

RESULTS

The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment (P < 0.05). The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group, and the difference was statistically significant (P < 0.05). The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group (P < 0.05). In the cognitive impairment group, the infarct volumes in the basal ganglia, thalamus, and mixed lesions were negatively correlated with the total MoCA score, with correlation coefficients of -0.67, -0.73, and -0.77, respectively.

CONCLUSION

In elderly patients with acute insular infarction, infarction in the basal ganglia, thalamus, and mixed lesions were more likely to lead to cognitive dysfunction than in other areas, and patients with large infarct volumes were more likely to develop cognitive dysfunction. The infarct volume in the basal ganglia, thalamus, and mixed lesions was significantly negatively correlated with the MoCA score.

Keywords: Elderly, Acute insular infarction, Infarction site, Cognitive impairment, Infarction volume

Core Tip: With the increasingly obvious aging of the population, the incidence of cerebral infarction is increasing year by year, which seriously leads to patient death. Most survivors suffer from sequelae such as cognitive dysfunction, aphasia and paralysis. This study aims to investigate the different clinical manifestations of patients with acute island infarction from the perspective of infarct location and volume, and mainly explore the influence of infarct location and volume on cognitive dysfunction in elderly patients with acute island infarction, hoping to evaluate cognitive function score, infarct location and volume. This can provide a basis for the clinical diagnosis and treatment of acute island infarction.