偏头痛患者的脑白质疏松程度 对其认知水平的影响

Effect of leukoaraiosis on cognitive function in patients with migraine

摘要:

目的 探讨偏头痛患者脑白质疏松（LA）程度对其认知水平的影响。方法 选取该院神经内科 门诊首次就诊的106 例偏头痛患者为研究对象，分为无先兆偏头痛组76 例（MOA 组）和有先兆偏头痛组 30 例（MA 组），并随机选取同期50 例来该院体检的健康成人为对照组。采用皮质下胆碱能通路高信号量表 （CHIPS）和蒙特利尔认知评估量表（MoCA）评价偏头痛患者LA 的严重程度与认知水平。采用Pearson 相 关系数分析偏头痛患者发作期、发作间期的CHIPS 总分与MoCA 各项目评分及总分的相关性。结果 ① MA 组的CHIPS 总分高于MOA 组和对照组，LA 发生率高于对照组（P <0.05）。②在发作期，MA 组的MoCA 全 部项目的评分和总分均低于对照组，语言、延迟回忆的评分及总分均低于MOA 组（P <0.05）；在发作间期， MA 组的命名、注意力、语言、抽象、延迟回忆的评分以及总分均低于对照组（P <0.05）；MA 组和MOA 组的 全部项目评分和总分比较，差异无统计学意义（P >0.05）。③ MOA 组发作期的CHIPS 总分与MoCA 语言、 延迟回忆的评分及总分呈负相关（P <0.05）；MA 组发作期的CHIPS 总分与MoCA 命名、注意力、语言延迟 回忆的评分以及总分呈负相关（P <0.05）。结论 偏头痛患者出现LA 和认知功能障碍的风险增加，且有先兆 偏头痛患者较无先兆偏头痛患者的LA 发生率更高。无论是有先兆偏头痛还是无先兆偏头痛德患者，其LA 程 度越重，发作期的认知水平越低，但在发作间期两者无相关性。

Abstract:

Objective To study the effect of leukoaraiosis (LA) on cognitive function in patients with migraine. Methods A total of 106 patients with migraine from January 2015 to March 2016 were enrolled in the study and divided into migraine without aura group (MOA group, n = 76) and migraine with aura group (MA group, n = 30), with 50 healthy individuals in the control group. Cholinergic pathways hyperintensities scale (CHIPS) and Montreal cognitive assessment scale (MoCA) were performed to evaluate the LA severity and cognitive level. Pearson correlation coefficient was used to analyze the correlation between CHIPS scores and MoCA scores in patients with migraine during attack period and intermission period. Results ① The CHIPS total score in MA group was significantly higher than that in MOA group and control group, the incidence of LA was significantly higher than that in control group (P < 0.05). The CHIPS total score in MOA group was significantly higher than that in control group (P < 0.05). ② During attack period, all the items scores and total score of MoCA in MA group were significantly lower than those in control group, and the scores of language, delayed recall and total score were significantly lower than those in MOA group (P < 0.05). During intermission period, the scores of naming, attention, language, abstraction, delayed recall and total score in MA group were significantly lower than those in control group (P < 0.05). There were no significant differences in all the items scores and total score of MoCA between MA group and MOA group during intermission period (P > 0.05). ③ CHIPS score was negatively related with the scores of language, delayed recall and total score of MoCA in MOA group during attack period (P < 0.05); CHIPS score was negatively related with the scores of naming, attention, language, delayed recall and total score of MoCA in MA group during attack period (P < 0.05). Conclusions Patients with migraine have a high risk of LA and cognitive impairment, and MA has a higher incidence of LA than MOA. For patients with MA and MOA, the higher the severity of LA is, the lower the cognitive level is during attack period, but there is no significant correlation between them during intermission period.