RESUMEN

Objective:To observe the changes of cognitive function, subcortical nuclei volumes, and diffusion kurtosis imaging (DKI) parameters (values of fractional anisotropy [FA], mean diffusivity [MD] and mean kurtosis [MK]) after surgery in patients with aneurysmal subarachnoid hemorrhage (aSAH), and analyze the correlations of cognitive dysfunction with subcortical nuclei volumes and DKI parameters.Methods:A prospective sutdy was conducted;17 patients with aSAH confirmed by surgery in our hospital from September 2019 to June 2020 were selected as patient group, and 16 healthy volunteers whose age, gender, and education level were matched with the patient group were recruited as control group. Neuropsychological tests and MR imaging were performed in the patients 3 months after surgery and the controls right after enrollment. The structural image data of all subjects were post-processed. Bilateral subcortical nuclei volumes and DKI parameters were analyzed. The differences of general clinical data, subcortical nuclei volumes and DKI parameters were compared between the two groups. The correlations of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores with subcortical nuclei volumes and DKI parameters were analyzed.Results:As compared with the control group, the patient group had significantly lower MMSE and MoCA scores, and statistically decreased volumes of ipsilateral hippocampus, ipsilateral thalamus and ipsilateral lentiform nucleus ( P<0.05). The FA values of the contralateral caudate nucleus, bilateral thalamus and bilateral lentiform nucleus and MK values of the ipsilateral hippocampus in the patient group were significantly decreased as compared with those in the control group ( P<0.05); while the MD values of the ipsilateral caudate nucleus in the patient group were significantly increased as compared with those in the control group ( P<0.05). The volume of ipsilateral hippocampus was positively with MoCA scores ( r=0.604, P=0.038); the FA values of contralateral caudate nucleus were negatively correlated with MMSE scores ( r=-0.579, P=0.049). Conclusions:Cognitive dysfunction, atrophy of ipsilateral hippocampus, thalamus and lenticular nucleus, and changes of DKI parameters exist in patients with aSAH after surgery. The changes in ipsilateral hippocampus volume and FA values of caudate nucleus may be related to the postoperative cognitive dysfunction in these patients.