Correlations among peripheral blood markers, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events

Abstract

BackgroundBoth inflammation and cerebral white matter injury are closely associated with vascular cognitive impairment (VCI). The aim of this study was to analyze the correlation between peripheral serological markers, white matter injury, and cognitive function in patients with non-disabling ischemic cerebrovascular events (NICE); to identify potential biological markers for the diagnosis and prediction of VCI; and to provide a basis for the early diagnosis and intervention of VCI.MethodsWe collected clinical data, along with demographic and medical history data, from 151 NICE patients. Fasting venous blood samples were collected. Based on the Montreal Cognitive Assessment (MoCA) after admission, we divided the patients into normal cognitive function (NCF) and VCI groups, and then classified them into mild white matter hyperintensity (mWMH) and severe white matter hyperintensity (sWMH) based on Fazekas scores. The differences in serological marker levels were compared between the cognitive function groups and the white matter hyperintensity groups. Binary logistic regression models and receiver operating characteristic curves were used to analyze the diagnostic predictive value of serological markers for VCI in patients with NICE and in the white matter hyperintensity subgroups.ResultsAmong 151 patients with NICE, 95 were male and 56 were female. Lymphocyte count (OR = 0.405, p = 0.010, 95% CI [0.201, 0.806]), red blood cell count (OR = 0.433, p = 0.010, 95% CI [0.228, 0.821]), and hemoglobin level (OR = 0.979, p = 0.046, 95% CI [0.958, 0.999]) were protective factors for cognitive function in patients with NICE. The sWMH group had a higher age, granulocyte/lymphoid ratio (NLR), and neutrophil percentage but a lower MoCA score, hemoglobin level, and lymphocyte count than the mWMH group. In the mWMH group, lymphocyte count (AUC = 0.713, p = 0.003, 95% CI [0.593, 0.833]) had an acceptable predictive value for the diagnosis of VCI, whereas white blood cell count (AUC = 0.672, p = 0.011, 95% CI [0.545, 0.799]), red blood cell count (AUC = 0.665, p = 0.014, 95% CI [0.545, 0.784]), and hemoglobin level (AUC = 0.634, p = 0.047, 95% CI [0.502, 0.765]) had marginal predictive value for the diagnosis of VCI. In the sWMH group, no significant differences were found in serological markers between the NCF and VCI groups.ConclusionLymphocyte count, red blood cell count, and hemoglobin level were independent protective factors for cognitive function in patients with NICE; they can be used as potential biological markers to distinguish VCI in patients with NICE and are applicable to subgroups of patients with mWMH.

Hyperforin ameliorates neuroinflammation and white matter lesions by regulating microglial VEGFR2/SRC pathway in vascular cognitive impairment mice

“…The “inflammatory mechanism” hypothesis, widely accepted as the dominant theory of VCI, has a crucial function in the processes of degradation and regeneration of myelin 4 . Our prior clinical and animal studies on VCI have consistently shown the crucial involvement of microglial activation and concomitant neuroinflammation in the progression of WMLs and cognitive dysfunction 5,6 . Moreover, our study has shown that distinct inhibition of microglial activation and neuroinflammatory response in the hippocampus leads to differential improvement in myelin repair and ultimately enhances cognitive function in VCI mice 7 .…”

“… 4 Our prior clinical and animal studies on VCI have consistently shown the crucial involvement of microglial activation and concomitant neuroinflammation in the progression of WMLs and cognitive dysfunction. 5 , 6 Moreover, our study has shown that distinct inhibition of microglial activation and neuroinflammatory response in the hippocampus leads to differential improvement in myelin repair and ultimately enhances cognitive function in VCI mice. 7 Neuroinflammation has the potential to cause WMLs, which are responsible for cognitive dysfunction.…”

Serum albumin and white matter hyperintensities

“…That is, whereas both HCV and albumin correlated with serum markers of liver function (i.e., aspartate transaminase, prealbumin; note, although prealbumin is sometimes considered a nutritional marker, Quest Diagnostics, states that "prealbumin is decreased in liver disease"), only albumin additionally correlated with hematological markers (i.e., lower red blood cell count, lower hemoglobin, lower hematocrit, and higher red cell distribution width). These relations between albumin and altered hemodynamic pro les have previously been reported [111] and may re ect cardiovascular dysfunction [112][113][114][115][116][117].…”

The associations between peripheral inflammatory and lipid parameters, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events

“…White matter hyperintensities (WMHs), recent small subcortical infarcts, cerebral microbleeds and perivascular spaces are all unique neuroimaging markers of VCI, in which WMHs are more able to reflect white matter injury [ 7 ]. In our prior investigation, we established a positive correlation between the severity of WMHs and the extent of cognitive decline in individuals afflicted with CVD [ 8 ].…”