Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2024; 12(19): 3815-3823
Published online Jul 6, 2024. doi: 10.12998/wjcc.v12.i19.3815
Cerebral arterial blood flow, attention, and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage
Ya-Zhao Zhang, Cong-Yi Zhang, Ya-Nan Tian, Yi Xiang, Jian-Hui Wei
Ya-Zhao Zhang, Yi Xiang, Jian-Hui Wei, Department of Neurosurgery, Hengshui People's Hospital, Hengshui 053000, Hebei Province, China
Cong-Yi Zhang, Department of Ultrasound, Second People's Hospital of Hengshui City, Hengshui 053000, Hebei Province, China
Ya-Nan Tian, Department of Neurology, Hengshui People's Hospital, Hengshui 053000, Hebei Province, China
Author contributions: Zhang YZ and Xiang Y design the experiment; Zhang CY drafted the work; Tian YN collected the data; Wei JH analyzed and interpreted data; Zhang YZ wrote the article.
Institutional review board statement: This study has been approved by the institutional review board of Hengshui People's Hospital.
Informed consent statement: The informed consent has been obtained from every patient.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: The data are available from the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
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: Yi Xiang, BM BCh, Chief Physician, Department of Neurosurgery, Hengshui People's Hospital, No. 180 Renmin East Road, Taocheng District, Hengshui 053000, Hebei Province, China. sjwkxy@163.com
Received: February 28, 2024
Revised: April 10, 2024
Accepted: May 24, 2024
Published online: July 6, 2024
Processing time: 122 Days and 8 Hours
Abstract
BACKGROUND

Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension, and surgery is currently the main treatment for hypertensive cerebral hemorrhage, but the bleeding caused by surgery will cause damage to the patient's nerve cells, resulting in cognitive and motor dysfunction, resulting in a decline in the patient's quality of life.

AIM

To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.

METHODS

Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group, while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group. The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test (WCST) and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The Hamilton Depression Rating Scale (HAMD-24) was used to evaluate the severity of depression of involved patients. Cerebral arterial blood flow was measured in both groups.

RESULTS

The MoCA score, net scores I, II, III, IV, and the total net score of the scratch test in the observation group were significantly lower than those in the control group (P < 0.05). Concurrently, the total number of responses, number of incorrect responses, number of persistent errors, and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group (P < 0.05). Blood flow in the basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery, and right anterior cerebral artery was significantly lower in the observation group than in the control group (P < 0.05). The basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery, and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score (P < 0.05), and negatively correlated with each part of the WCST test (P < 0.05). In the observation group, the post-treatment improvement was more prominent in the Paddle Pin test, WCST test, HAMD-24 score, and MoCA score compared with those in the pre-treatment period (P < 0.05). Blood flow in the basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery, and right anterior cerebral artery significantly improved in the observation group after treatment (P < 0.05).

CONCLUSION

Impaired attention, and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.

Keywords: Acute hypertensive cerebral hemorrhage, Depression, Cerebral arterial blood flow, Attention, Executive ability, Cognitive function

Core Tip: Through a cohort of studies of visiting patients, we have concluded that impaired attention, executive and cognitive function in depressed patients after acute hypertensive intracerebral hemorrhage are associated with cerebral arterial blood flow, and these results require more research.