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. 2022 Aug 25;14(8):e28397.
doi: 10.7759/cureus.28397. eCollection 2022 Aug.

Assessment of Cognition in Hypertensives and Normotensives: A Comparative P300 Study

Yeswanth Gogisetti  1 , Monika Pathania  2 , Sunita Mittal  3 , Pradeep Yadav  4 , Prabin Kharibam  2 , Ravi Kant  2   5
Affiliations

Assessment of Cognition in Hypertensives and Normotensives: A Comparative P300 Study

Yeswanth Gogisetti et al. Cureus. .

Abstract

Background: Hypertension is an established risk factor for dementia, and the prevalence of hypertension and dementia is rising. Current tests to diagnose cognitive dysfunction at an early stage lack sensitivity and specificity. Recently event-related potentials (ERPs) have gained much attention in diagnosing cognitive dysfunction and are independent of the education status of the subject. This study was done to find any cognitive deficits in the hypertensive population with electrophysiological evidence, which might open the doors for the need to screen the population at an earlier stage so that the population can be prevented from dementia.

Methods: Some 31 middle-aged (18-65 years) hypertensives were compared with 31 age, sex, education, and handedness matched normotensives about cognition by neuropsychometric test battery including Hindi Mini-mental Status Examination (HMSE), Hindi Montreal Cognitive Assessment (MoCA), choice reaction time (CRT), and auditory event-related potentials.

Results: Hypertensives and normotensives differed significantly concerning P300 potentials' latency (Fz and Cz P300 latencies: p-value: 0.001), and this change was correlated well with the duration of diastolic blood pressure (BP) (r-value: 0.670). The remaining tests, HMSE, Hindi MoCA, and CRT, were dependent on the education status of the patient.

Conclusions: The effect of hypertension on cognitive impairment is evident and can be proved early in its pre-clinical stage using ERPs. Early identification can help in specifying high-risk individuals. ERPs have great potential in screening and diagnosing and can also help in assessing cognition as a reliable tool to show the effect of treatments/interventions on cognitive defects.

Keywords: auditory p300; choice reaction time; hypertension; mmse; moca.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study flow chart.
Figure 2
Figure 2. Effect of education on HMSE and Hindi MoCA.
p-value: <0.001 for both HMSE and MoCA HMSE, Hindi Mini-mental Status Examination; MoCA, Montreal Cognitive Assessment
Figure 3
Figure 3. Correlation of SBP, DBP, MAP, and duration of hypertension with Cz P300, with a correlation coefficient of 0.35, 0.439, 0.405, and 0.418, respectively.
SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure
Figure 4
Figure 4. Correlation of SBP, DBP, MAP, and duration of hypertension with Fz P300, with a correlation coefficient of 0.428, 0.49, 0.47, and 0.67, respectively.
SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure
Figure 5
Figure 5. Correlation of Hindi MoCA with HMSE.
MoCA, Montreal Cognitive Assessment; HMSE, Hindi Mini-mental Status Examination
Figure 6
Figure 6. Correlation of HMSE and Hindi MoCA with CRT. The correlation coefficient of HMSE and CRT are -0.49 and -0.709 for Hindi MoCA with CRT.
HMSE, Hindi Mini-mental Status Examination; CRT, choice reaction time; MoCA, Montreal Cognitive Assessment
Figure 7
Figure 7. Case proforma used in initial evaluation of subjects.
Figure 8
Figure 8. Subject performing auditory P300 test.
Figure 9
Figure 9. Electrode placement site over the scalp for auditory P300 test.
Figure 10
Figure 10. Sample ERP graph with marking of potentials.
ERP, event-related potential
Figure 11
Figure 11. Hindi MMSE.
MMSE, Mini-Mental Status Examination
Figure 12
Figure 12. Hindi MoCA.
MoCA, Montreal Cognitive Assessment
Figure 13
Figure 13. Sample of CRT screenshot.
A - sample CRT screenshot where ‘x’ or ‘2’ to be pressed; B - inter-stimulus screen in CRT; C - sample CRT screenshot where ‘,’ or ‘3’ to be pressed CRT, choice reaction time
See this image and copyright information in PMC

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