Cognitive impairment

Introduction Cognitive function is a complex process of mental activity. When a person's cognitive function changes, a series of changes, including thinking, emotion, will, and behavior, will occur. People with cognitive impairment have special personality characteristics, such as loneliness, introversion, sensitivity, lack of logic in thinking, and good fantasy. Some people call it a split-like personality or a split-like latent quality (or a susceptibility). In patients with schizophrenia, 50% to 60% of patients have schizophrenic susceptibility.

Cause

Vascular cognitive impairment refers to varying degrees of cognitive impairment due to vascular factors. The most widely accepted concept of VCI is the varying degrees of cognitive impairment due to vascular factors. In this concept, vascular factors mainly refer to the blood vessels in the brain, that is, the two systems of the carotid artery and the vertebral basilar artery, which may be the lesions of these blood vessels themselves, or the extracranial large blood vessels and the lesions of the heart indirectly affect the blood in the brain. perfusion.

Hachinski also divides vascular factor brain damage into three phases:

1 brain risk stage (such as the risk factors for VCI);

2 pre-symptomatic phase (cerebral vascular events have been confirmed by neurology and radiology, but there are no symptoms of cognitive impairment);

3 symptom stages. In the past, the incidence of VCI was caused by the accumulation of recurrent cerebral infarction, which led to the decline of cognitive function.

It is now believed that its mechanisms may include:

1 ischemia causes softening and necrosis of brain tissue in the blood supply area, loss of functional tissue and damage leading to cognitive decline;

2 small vessel disease is closely related to the pathogenesis of VCI;

3 Chronic ischemia causes white matter damage, axonal transport is impaired, and local inflammatory reaction causes obstacles in information transmission; 4 neuronal injury and/or loss is the final link leading to clinical symptoms, signs and various cognitive declines.

an examination

Related inspection

EEG sharp wave EEG examination

After schizophrenia improves its mental function, its ability and level of work have not recovered. This indicates that mental symptoms are not an effective indicator to measure social function in patients with schizophrenia. This means that cognitive function limits the ability of patients. Traditional antipsychotic drugs do not improve negative symptoms and cognitive function while improving positive psychotic symptoms, while negative symptoms and cognitive function are closely related to the functional outcome of the disease. The cognitive function test found that the cognitive function of schizophrenia is closely related to negative symptoms, and cognitive function is the most reliable indicator for predicting the functional outcome of schizophrenia. Detection of cognitive impairment is important for predicting personality traits and diseases, but those with susceptibility are not necessarily destined to have a disease, but must also have a comprehensive set of conditions. The understanding of cognitive function defects plays an important role in formulating corresponding mental health education programs and early prevention and intervention.

Differential diagnosis

Vascular cognitive impairment:

1 vascular dementia (including MID, important sites of infarct dementia, Binswanger disease, etc.);

2 AD with vascular components (also known as mixed AD);

3 Vascular cognitive impairment (VCIND) that does not meet the diagnostic criteria for dementia.

The diagnostic VCIND standard is:

1 The patient has cognitive impairment, but does not meet the third edition of the American Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) dementia criteria (such as memory impairment and other cognitive impairments that cause functional decline);

2 cognitive damage caused by vascular factors (such as clinical features of acute onset, the course of aggravation of the ladder, cognitive function tests for patchy defects, signs of focal nervous system, evidence of other atherosclerosis; imaging Evidence support.

After schizophrenia improves its mental function, its ability and level of work have not recovered. This indicates that mental symptoms are not an effective indicator to measure social function in patients with schizophrenia. This means that cognitive function limits the ability of patients. Traditional antipsychotic drugs do not improve negative symptoms and cognitive function while improving positive psychotic symptoms, while negative symptoms and cognitive function are closely related to the functional outcome of the disease. The cognitive function test found that the cognitive function of schizophrenia is closely related to negative symptoms, and cognitive function is the most reliable indicator for predicting the functional outcome of schizophrenia. Detection of cognitive impairment is important for predicting personality traits and diseases, but those with susceptibility are not necessarily destined to have a disease, but must also have a comprehensive set of conditions. The understanding of cognitive function defects plays an important role in formulating corresponding mental health education programs and early prevention and intervention.

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