Relationship between cognitive impairment and apparent diffusion coefficient values from magnetic resonance-diffusion weighted imaging in elderly hypertensive patients

Figures & data

Figure 1 Chart of the participants enrolled in this study.

Abbreviations: Rt, routine test; MoCA, Montreal Cognitive Assessment; CDR, Clinical Dementia Rating Assessment; MCI, mild cognitive impairment; VD, vascular dementia; MR-DWI, magnetic resonance-diffusion weighted imaging.

Table 1 Demographic and clinical characteristics of participants

Parameter	Control group (n=20)	Normal group (n=33)	MCI group (n=80)	VD group (n=58)	P-valued
Age, yearsa	71.21±4.67 (60–79)	71.15±5.76 (60–79)	71.25±3.88 (60–79)	71.14±5.11 (60–79)	0.984
Genderb					0.924
Male	10 (50)	19 (58)	46 (58)	34 (59)
Female	10 (50)	14 (42)	34 (42)	24 (41)
Apo Ac	1.25±0.04	1.25±0.04	1.34±0.22	1.27±0.30	0.111
Apo B100c	1.060±0.12	1.07±0.11	1.03±0.16	1.00±0.17	0.161
LP(a)c	34.267±8.20	33.36±5.05	27.41±20.97	32.47±26.12	0.288
TGc	1.878±0.87	1.85±0.86	1.75±0.99	1.77±1.61	0.956
TCc	3.982±1.04	3.97±1.03	4.10±0.95	3.91±0.81	0.668
HDL-Cc	1.21±0.17	1.24±0.18	1.25±0.27	1.34±0.27	0.092
LDL-Cc	2.37±0.55	2.37±0.52	2.61±0.59	2.66±0.64	0.051
HDL-C/LDL-Cc	0.53±0.11	0.54±0.10	0.50±0.15	0.52±0.14	0.521
FBGc	5.31±0.67	5.58±1.18	5.33±0.74	5.67±0.64	0.057
PBGc	9.29±2.05	9.22±2.31	9.31±4.52	9.32±2.31	0.999
HbA1cc	5.81±1.36	5.69±1.64	5.92±1.32	6.34±1.40	0.134
Statinsb					0.063
Taking	8 (40)	13 (39)	45 (56)	20 (35)
Not taking	12 (60)	20 (61)	35 (44)	38 (65)

Notes: Unless otherwise indicated, data are numbers of participants, with percentages in parentheses.

a Data are means ± standard deviations, with ranges in parentheses.

b Data are numbers with percentages in parentheses.

c Data are means ± standard deviations.

d Analysis of variance and χ² tests.

Abbreviations: Apo A, apolipoprotein A; Apo B100, apolipoprotein B100; FBG, fasting blood glucose; HbA_1c, glycated hemoglobin; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; LP(a), lipoprotein (a); MCI, mild cognitive impairment; PBG, postprandial blood glucose; TC, total cholesterol; TG, total triglyceride; VD, vascular dementia.

Table 2 MoCA scores, CDR scores, and blood pressure values of the four groups

Parameter	Control group (n=20)	Normal group (n=33)	MCI group (n=80)	VD group (n=58)	P-valuec
MoCA scorea	30.00±0.00	27.91±1.59	23.24±1.95	19.21±2.71	0.000d
CDR scorea	0.00±0.00	0.00±0.00	0.43±0.17	0.95±0.15	0.000d
SBPa	130.60±5.20	142.06±5.51	152.14±10.62	160.87±11.56	0.000d
DBPa	75.70±6.91	84.35±4.69	90.19±6.96	97.55±6.79	0.000d
Hypertension historya	0.00±0.00	7.36±7.84	18.44±9.47	20.29±7.64	0.000d
Hypertensionb					0.000d
Stage 1	–	33 (100)	25 (31)	12 (21)
Stage 2	–	0 (0)	55 (69)	46 (79)

Notes:

a Data are means ± standard deviations.

b Data are numbers, with percentages in parentheses.

c Analysis of variance and χ² tests.

d Control, normal, and MCI groups different from VD group (P<0.001).

Abbreviations: CDR, Clinical Dementia Rating Assessment; DBP, diastolic blood pressure; MCI, mild cognitive impairment; MoCA, Montreal Cognitive Assessment; SBP, systolic blood pressure; VD, vascular dementia.

Table 3 Analysis of the MoCA and CDR scores and region-based analysis of mean ADC values in brain regions for the two hypertension stages in elderly hypertensive participants

Score and brain region	Stage 1 (n=70)	Stage 2 (n=101)	F-value	P-valuea
MoCA	25.14±3.56	21.13±2.97	0.013	0.000b
CDR	0.35±0.37	0.64±0.33	3.401	0.000b
Right centrum ovale	0.89±0.12	0.88±0.10	2.805	0.458
Left centrum ovale	0.84±0.12	0.86±0.09	4.763	0.226
Right hippocampus	1.82±0.23	1.88±0.20	2.292	0.117
Left hippocampus	1.78±0.24	1.86±0.19	12.189	0.020c
Right thalamus	0.92±0.16	0.93±0.11	13.626	0.566
Left thalamus	0.87±0.14	0.94±0.13	2.879	0.002c
Right internal capsule	0.85±0.11	0.88±0.15	9.143	0.136
Left internal capsule	0.83±0.11	0.87±0.12	1.374	0.032c
Right lenticular nucleus	1.00±0.12	0.98±0.15	7.546	0.220
Left lenticular nucleus	1.00±0.11	0.96±0.15	9.042	0.028c
Right caudate nucleus	0.86±0.11	0.86±0.12	0.146	0.982
Left caudate nucleus	0.83±0.08	0.86±0.12	13.362	0.108
Right temporal lobe cortex	1.29±0.37	1.56±0.23	47.288	0.000b
Left temporal lobe cortex	1.16±0.29	1.47±0.19	29.288	0.000b
Right occipital lobe cortex	1.31±0.32	1.51±0.23	22.729	0.000b
Left occipital lobe cortex	1.18±0.28	1.34±0.23	6.384	0.000b

Notes: Data are means ± standard deviations.

a Analysis of t-test.

b Stage 1 group differs from stage 2 group (P<0.001).

c Stage 1 group differs from stage 2 group (P<0.05).

Abbreviations: ADC, apparent diffusion coefficient; CDR, Clinical Dementia Rating Assessment; MoCA, Montreal Cognitive Assessment.

Table 4 Mean ADC values in brain regions for the four groups

Brain region	Control group (n=20)	Normal group (n=33)	MCI group (n=80)	VD group (n=58)
Right centrum ovale	0.71±0.05	0.79±0.06	0.86±0.09	0.97±0.09
Left centrum ovale	0.70±0.04	0.77±0.05	0.83±0.08	0.94±0.10
Right hippocampus	0.87±0.02	1.67±0.14	1.83±0.22	1.99±0.13
Left hippocampus	0.86±0.02	1.61±0.16	1.81±0.22	1.96±0.11
Right thalamus	0.76±0.02	0.89±0.17	0.91±0.12	0.96±0.11
Left thalamus	0.74±0.02	0.89±0.15	0.90±0.13	0.95±0.12
Right internal capsule	0.70±0.04	0.79±0.11	0.88±0.13	0.88±0.13
Left internal capsule	0.70±0.03	0.78±0.10	0.87±0.12	0.88±0.11
Right lenticular nucleus	0.72±0.03	0.97±0.09	0.98±0.16	1.00±0.13
Left lenticular nucleus	0.70±0.03	0.96±0.11	0.97±0.15	0.99±0.12
Right caudate nucleus	0.77±0.03	0.85±0.10	0.86±0.12	0.87±0.12
Left caudate nucleus	0.76±0.03	0.82±0.08	0.84±0.10	0.87±0.12
Right temporal lobe cortex	0.85±0.03	0.96±0.06	1.53±0.28	1.62±0.14
Left temporal lobe cortex	0.84±0.03	0.92±0.08	1.43±0.25	1.52±0.13
Right occipital lobe cortex	0.83±0.04	1.00±0.08	1.46±0.24	1.61±0.12
Left occipital lobe cortex	0.81±0.03	0.98±0.07	1.28±0.28	1.43±0.13

Note: Data are means ± standard deviations.

Abbreviations: ADC, apparent diffusion coefficient; MCI, mild cognitive impairment; VD, vascular dementia.

Table 5 Comparison of mean ADC values in brain regions between different groups

Brain region	Control group versus normal group		Normal group versus MCI group		MCI group versus VD group
	F-value	P-valuea	F-value	P-valuea	F-value	P-valuea
Right centrum ovale	2.660	0.000b	3.463	0.000b	0.036	0.000b
Left centrum ovale	0.323	0.000b	8.875	0.000b	0.912	0.000b
Right hippocampus	25.578	0.000b	7.751	0.000b	15.759	0.000b
Left hippocampus	20.383	0.000b	5.325	0.000b	23.940	0.000b
Right thalamus	25.137	0.000b	3.685	0.516	0.921	0.013c
Left thalamus	28.376	0.000b	0.799	0.743	0.781	0.017c
Right internal capsule	21.785	0.000b	1.222	0.001c	0.139	0.884
Left internal capsule	14.452	0.000b	3.317	0.000b	1.354	0.553
Right lenticular nucleus	16.322	0.000b	11.185	0.590	3.332	0.331
Left lenticular nucleus	12.006	0.000b	4.723	0.638	2.781	0.338
Right caudate nucleus	17.842	0.000b	1.410	0.752	0.991	0.673
Left caudate nucleus	7.889	0.000b	2.412	0.287	2.334	0.129
Right temporal lobe cortex	10.215	0.000b	34.122	0.000b	21.625	0.019c
Left temporal lobe cortex	12.324	0.000b	31.411	0.000b	23.694	0.015c
Right occipital lobe cortex	8.632	0.000b	24.774	0.000b	17.804	0.000b
Left occipital lobe cortex	9.496	0.000b	39.122	0.000b	30.591	0.000b

Notes: Data are means ± standard deviations.

a Analysis of t-test.

b Control, normal, and MCI groups differ from VD group (P<0.001).

c Control, normal, and MCI groups differ from VD group (P<0.05).

Abbreviations: ADC, apparent diffusion coefficient; MCI, mild cognitive impairment; VD, vascular dementia.