Muthu, T (2012) Cognitive Dysfunction in Small Vessel Disease. Masters thesis, Madras Medical College, Chennai.
|
Text
160100112muthu.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: Cerebral small vessel disease is an important risk factor for stroke and cognitive dysfunction in the elderly population. Most often small vessel disease are asymptomatic, presenting as white matter hyperintensities. Detailed clinical evaluation may reveal cognitive dysfunction. Vascular risk factors may predispose to the occurrence of small vessel disease, as these white matter changes are believed to be of ischemic in origin. AIM AND OBJECTIVE: 1. To study the clinical cognitive dysfunction in asymptomatic patients, presenting with white matter hyperintensities. 2. To study the correlation between the extent of white matter changes, as assessed by Fazekas visual rating scale and degree of cognitive dysfunction. MATERIALS AND METHODS: Patients aged more than 40yrs, presenting with white matter hyperintensity without higher mental function disturbance were included. Those with MMSE<9, terminal illness, fulfilling criteria for Alzheimers’s disease and psychiatric illness were excluded. Total of 38 patients were studied. White matter changes were rated as mild, moderate and severe by Fasekas visual rating scale. Detailed higher mental function and individual lobar functions were evaluated and correlation assessed. Various risk factors were analysed. RESULTS: Age is found to be the most important risk factor, and white matter changes increase with age. Hypertension and smoking were also strong risk factors. On clinical evaluation, psychomotor slowing was observed in 55% of patients with small vessel disease. Higher cognitive function like social judgement, abstract thinking were affected in 47% of patients. Executive dysfunction and impairment in alternate sequence was noted in 39% of subjects. Attention was impaired in 37% cases. Memory was involved in 21% of patients. On evaluating the MRI changes by visual rating scale, moderate degree of white matter changes were observed in most of the patients52%. Strong correlation existed between the severity of white matter changes and psychomotor slowing and higher cognitive involvement but statistical significance could not be obtained due to small cohart. CONCLUSION: Asymptomatic, subclinical involvement of cognitive function was observed in patients with cerebral small vessel disease. Psychomotor slowing and higher cognitive function impairment were most commonly observed. As small vessel disease may cause significant impairment in activities of daily living, primary prevention by attending to the vascular risk factors is the best way to prevent morbidity in elderly population.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | cerebral small vessel disease, white matter hyperintensity, psychomotor slowing, higher cognitive function. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Feb 2020 00:50 |
| Last Modified: | 11 Feb 2020 00:50 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11898 |
Actions (login required)
 |
View Item |
