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Correlation between clinical and imaging findings concerning cognitive dysfunction in after stroke hypertensive patients with type 2 diabetes mellitus

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Annals of General Psychiatry20065(Suppl 1):S127

https://doi.org/10.1186/1744-859X-5-S1-S127

Published: 28 February 2006

Keywords

  • Dementia
  • Uric Acid
  • Hypertensive Patient
  • Arterial Hypertension
  • Arterial Blood Pressure

Background

Previous studies have suggested that hypertensive patients with type 2 diabetes mellitus could lead to learning and memory deficits especially after stroke. Mini Mental State Examination (MMSE) is the most common cognitive function test which has been used to evaluate the degree of cognitive dysfunction. The subjects diagnosed with stroke are usually submitted to brain CT. The aim of our study was to correlate clinical and imaging findings in after stroke patients.

Materials and methods

22 patients mean age 77 ± 5 years old, having history of arterial hypertension and type 2 diabetes mellitus were admitted to our clinic for an ischemic stroke. According to MMSE scores patients were classified to four categories: A) 0–10: severe cognitive dysfunction, B) 11–20: moderate cognitive dysfunction, C) 21–27: mild to possible, D) 28–30: absence of cognitive dysfunction. Radiological criteria of dementia such as brain atrophy, dilatation of the ventricles, porencephalia and enlargement of scissures were searched. Arterial blood pressure, blood glucose levels, cholesterol, triglyceride, HDL and uric acid were measured.

Results

  1. 1.

    See Table 1.

     
Table 1

Classification of patients according to MMSE score

MMSE score

Patients (n)

0–10

3

11–20

9

21–24

3

25–27

5

28–30

2

  1. 2.

    See Table 2.

     
Table 2

CT results in each group

MMSE score

Patients

Findings in CT-scan

  

Brain atrophy

Without Brain Atrophy

0–10

3

3 i.i.*

0 i.i.

11–20

9

8 i.i.

1 i.i.

21–24

3

2 i.i.

1 i.i.

25–27

5

2 i i.

1 i.i.

28–30

2

2 i.i.

0 i.i.

*i.i. = ischemic infarct

3. a. Mean arterial blood pressure: SBP: 169.6 ± 22.9, DBP: 85.3 ± 22.8, b. Uric acid: 5.49 ± 2 mg/dl, c. total cholesterol: 201.4 ± 48.7 mg/dl, d. HDL: 50.6 ± 17.2 mg/dl, triglycerides: 144.2 ± 59 mg/dl, e. glucose: 140.7 ± 57, 3 mg/dl.

Discussion

1) The cognitive dysfunction even dementia is correlated with findings of brain atrophy while only the later can not constitute a safe indicator for the diagnosis of dementia. 2) The possibility of CT findings of brain atrophy increases significantly when the MMSE score decreases. 3) Arterial hypertension and diabetes mellitus seem to remain the main risk factors even under medications while the new ones such as elevated uric acid and triglycerides, as constituents of the metabolic syndrome, are found within the normal limits.

Authors’ Affiliations

(1)
Aristotle University of Thessaloniki, 1st Medical Propedeutic Dept, AHEPA, Greece

References

  1. Nagga K, Radberg C, Marcusson J: CT brain findings in clinical dementia investigation – underestimation of mixed dementia. Dement Geriatr Cogn Disord. 2004, 18: 59-66. 10.1159/000077737.View ArticlePubMedGoogle Scholar
  2. Mogi N, Hattori A, Ushida C, Umegaki H, Miura H, Iguchi A: Cognitive function and brain atrophy in elderly type 2 diabetic patients in comparison with non-diabetic elderly subjects. Nippon Ronen Igakkai Zasshi. 2001, 38: 388-92.View ArticlePubMedGoogle Scholar
  3. Condefer KA, Haworth J, Wilcock GK: Prediction rules for computed tomography in thedementia assessment: do they predict clinical utility of CT. Int J Geriatr Psychiatry. 2003, 18: 285-287. 10.1002/gps.812.View ArticlePubMedGoogle Scholar
  4. Kurita A, Black RS, Blass JP, Deck MD, Nolan KA: Failure of CT scan to detect ischemic lesions in patients with dementia. J Geriatr Psychiatry Neurol. 1993, 6: 245-50.View ArticlePubMedGoogle Scholar

Copyright

© The Author(s) 2006

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