Background: Hypertension (HTN) is the cause of mild cognitive impairment (MCI) with negative impact on the frontal lobes’ functioning (FL) The MCI prevalence in HTN patients is higher than non-hypertensive patients at the same age. Aims: Identify the level of association between the FL dysfunction and the brain lesions detected by neuro imaging in HTN controlled patients. Materials and Methods: In a sample of 60 HTN controlled patients with MCI higher than non-hypertensive patients, only 21 were evaluated with neuro imaging on diagnosis (CT / MRI) and included in this trial. The cognitive tests used were: Mini-Mental State Examination (MMSE), Clock Drawing Test , Trial Making Test , Stroop test, alternating sequences and Boston test. Results: Age 78.1±8.1 y (63-93), 57.1% male. The SBP 133.5 ± 15.7 mm Hg, la DBP 76.1 ± 13.5 mm Hg and PP 57.4 ± 11.3 mm Hg. All patients had primary school of which 28.6% had a higher education level. The MMSE was 25.8 ± 3.5 pts. Imaging: global atrophy according to age in 71.4% and 19% localized atrophy (frontal =3, temporo-parietal=1). Twelve had subcortical WM lesions (periventricular and subcortical). In the test that evaluated the FL functioning the 71% evidenced alterations and is not association with brain lesions in FL (Chi2, p=ns).
Conclusions in this sample: 1) the functions of the FL were more affected in patients with HTN, 2) Only 3 patients had frontal lobe lesions, 3) there was not association between cognitive frontal impairment and brain lesions 4) the cognitive assessment is greater than the neuro imaging for early diagnosis of functional brain damage in hypertensive patients. These results support the hypothesis of a disconnection syndrome by subcortico-prefrontal white matter demyelination (SB) and / or hypoperfusion of the LF may be due to frontal dysfunction.
Publication: September - November 2011
Your questions, contributions and commentaries will be answered
by the lecturer or experts on the subject in the High Blood Pressure list.
Please fill in de form and Press the "Send" button.