No abstract

Background and Objective. White matter lesions (WMLs) are imaging changes characterized by hyperintensities on T2-weighted or FLAIR images, which are closely related to the decline of cognitive function. However, the etiology and pathogenesis of WMLs remain undetermined. The aim of this study was to analyze the relationship between adiponectin levels and cognitive decline in persons with or without white matter lesions. Method. In the present study, 126 patients, 90 cases in the WML group and 36 cases in the control group, were analyzed to explore the relationship between adiponectin and WMLs. All patients underwent an MRI scan to assess whether white matter lesions happened. And the serum levels of adiponectin were detected by ELISA. Results. In this study, according to Fazekas criteria, WMLs were divided into different severity groups. With the increase of WML score, the level of adiponectin decreased, and linear correlation analysis shows that adiponectin is negatively correlated with the severity of white matter lesions ( p < 0.001 ). And adiponectin level was significantly positively correlated with MoCA score ( p < 0.05 ). Moreover, adiponectin in the WMLs combined with the cognitive impairment group was significantly reduced ( p < 0.01 ). Conclusion. The level of adiponectin is independently associated with WMLs and cognitive function, which suggests that adiponectin may be a protective factor for WMLs and cognitive function.

Background: Hemiplegia is a common symptom after acute cerebral infarction. Objective: This study aimed to explore the influence factors of gait performance and investigate whether donepezil could improve gait performance in patients with an acute cerebral infarction. Methods: A total of 107 patients who experienced unilateral paresis after an acute cerebral infarction incident were enrolled in this prospectively observational study. Participants underwent 3-month assessment. At the study's conclusion, patients were divided into 2 groups-those received daily donepezil (observation Group) and those not (Control Group). Results: There was significant difference (t=3.269, p=0.001) of Wisconsin Gait Scale (WGS) score between single site infarction (27.11±6.65) and multiple sites infarction (31.54±6.42). For gender, smoking, drinking, hypertension, hyperlipidemia and diabetes, there was no difference of WGS scores between subgroups (p>0.05), respectively. Patient's admission National Institute of Health Stroke Scale(NIHSS) score had strongly positive correlation with WGS score (r=0.850, p<0.001). Besides, age (r=0.218, p=0.024), glycosylated hemoglobin (r=0.274, p=0.004), MMSE (r=-0.261, p=0.007) and Montreal Cognitive Assessment (MoCA) (r=-0.272, p=0.005) had weakly correlation with WGS scores. Multivariate analysis showed age (95% CI: 0.042~0.188, p=0.002), admission NIHSS score (95% CI: 2.405~3.137, p<0.001) and multiple sites infarction (95% CI: 0.044~2.983, p=0.044) were independent risk factors of WGS scores. WGS scores of both observation and control groups gradually decreased after admission (p<0.001). At 3 months after admission, WGS score of observation group was significantly lower than control group (t=2.468, p=0.015). There were no significant differences between observation and control group at admission and 1 month after admission (p>0.05). And WGS scores of both single site and multiple sites infarction gradually decreased at one month and three months after admission (p<0.001), while there were no significant difference between two groups (p>0.05). Conclusion: Admission NIHSS score, age and multiple sites infarction were independent risk factors of WGS score. Donepezil could improve gait performance in patients with an acute cerebral infarction.