Hemorheological disturbances and cognitive function in patients with cerebrovascular disease

摘要

Abstract. The aim of the study was to follow the relationship of the hemorheological variables with the cognitive functionsnin patients with ischemic cerebrovascular disease (CVD). The patient material comprised 117 patients with CVD, distributednin two main groups: 44 with transient ischemic attacks (TIAs) and 73 with chronic cerebral infarctions (CCI), 48 of themnbeing unilateral (UCI) and 25 bilateral (BCI). Additional relative distribution according to the mean arterial blood pressuren(MABP) values or to the presence of pathological asymmetries of the hemispheric cerebral blood flow (CBF) was made. Thenmain hemorheological variables: hematocrit (Ht), fibrinogen (Fib) and plasma viscosity (PV) were examined. The cognitivenfunctions were assessed with a psychological test battery for evaluation of the general cognitive state, the nonverbal intellect, thenepisodic memory, the selective attention and the executive functions. The hemorheological investigation revealed predomonantnincrease of PV. The results of all neuropsychological tests showed significant impairment in the patients with CCI in comparisonnto TIAs. Fibrinogen correlated best with the psychological parameters. Its increase was associated with disturbance of thennonverbal intellect and the general cognitive capacity in the patients with CCI and BCI. In the presence of lower MABP ornlack of pathological asymmetries the correlations of Fib and PV with the psychological scores predominated. The results ofnour study reveal distinct association between the blood rheological properties and the cognitive functions in the patients withnischemic CVD, which is probably based not only on vascular but also on other nonvascular mechanisms.