Changes of mini-mental state examination and Montreal cognitive assessment scores in patients with silent brain infarction and their relationship with the effect of dual antiplatelet aggregation therapy

Wu Xiaokun; Qi Wenshuai; Zu Zhe; Fu Zijuan; Ma Yuanyuan; Zhang Jinxia

doi:10.3760/j.issn.1673-4777.2025.06.010

Abstract：Objective To investigate the changes of mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores in patients with silent brain infarction(SBI)and their relationship with the effect of dual antiplatelet aggregation therapy.Methods A total of 110 SBI patients admitted to North China University of Science and Technology Affiliated Hospital from August 2022 to October 2023 were retrospectively analyzed.According to the treatment regimen,the patients were divided into conventional group(50 cases)and dual antibody group(60 cases).The conventional group was treated with bay aspirin,and the dual antibody group was treated with dual antiplatelet aggregation therapy(aspirin and clopidogrel bisulfate).The general data of the patients were collected,and the levels of nervous system markers,cognitive function,and coagulation function were detected before treatment,1 and 3 months after treatment,and the clinical effect of the patients after 3 months of treatment was evaluated.Logistic regression equation was used to analyze the risk factors affecting the clinical efficacy of SBI patients.Receiver operating characteristic curve analysis was used to evaluate the predictive value of cognitive function before treatment for clinical efficacy.Results After 1 and 3 months of treatment,the levels of nerve growth factor and brain-derived neurotrophic factor(BDNF),MMSE and MoCA scores in both groups showed an upward trend,and the scores in the dual antibody group were higher than those in the conventional group at each time point(all P＜0.05).After 1 and 3 months of treatment,the levels of neuron-specific enolase(NSE),glial fibrillary acidic protein factor,fibrinogen(FIB),maximum platelet aggregation rate,and D-dimer in the two groups showed a decreasing trend compared with those before treatment,and those in the dual antibody group were lower than those in the conventional group at each time point(all P＜0.05).After 3 months of treatment,the effective rate of the dual antibody group was higher than that of the conventional group[86.7％(52/60)vs 70.0％(35/50)](x2=4.581,P=0.032).Logistic regression analysis showed that past history,smoking history,drinking history,BDNF,NSE,FIB,D-dimer levels before treatment,MMSE and MoCA scores were the influencing factors of clinical efficacy in patients with SBI(all P＜0.05).The receiver operating characteristic curve analysis showed that the area under the curve of MMSE and MoCA combined to predict the clinical efficacy of SBI patients was 0.848.Conclusions Dual antiplatelet aggregation therapy can effectively improve the level of neurological markers,cognitive level and coagulation function in patients with SBI.At the same time,the level of cognitive function after the onset of SBI has a significant impact on the long-term clinical prognosis of patients.In the process of clinical treatment,in addition to monitoring the clinical symptoms of patients,The cognitive function of patients should be evaluated in time to obtain the best treatment effect.