Efficacy of enhanced extracorporeal counterpulsation combined with atorvastatin in the treatment of cognitive impairment after stroke

Abstract

Background: Cerebral apoplexy patients are prone to cognitive impairment, and it is very important to choose appropriate treatment methods to improve their cognitive impairment after stroke.

Aim: To evaluate the effects of enhanced external counterpulsation (EECP) in conjunction with atorvastatin on cognitive function, neurotransmitter levels, and the repair of brain tissue damage in patients with cognitive impairment due to stroke.

Methods: In this retrospective study, data from 60 patients with poststroke cognitive impairment due to stroke who were treated in our hospital from February 2021 to July 2022 were analyzed and divided into a treatment group (n = 30) and a control group (n = 30) according to the different nursing methods applied. Patients in the treatment group received EECP in addition to atorvastatin, while those in the control group received atorvastatin alone. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale scores were compared between the two groups. Additionally, the two groups were compared in terms of serum acetylcholine (ACh), acetylcholinesterase (AChE), nitric oxide (NO), endothelin-1 (ET-1), β2-microglobulin (β2-MG), glial fibrillary acidic protein (GFAP), and visinin-like protein 1 (VILIP-1) in the serum. Blood flow measurements from the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) were compared between the two groups before and after treatment, and the pulsatility index (PI) and resistance index (RI) of each artery were determined.

Results: MMSE, MoCA, and ADL scores all improved in both groups following treatment, with the study group showing more improvement than the control group (P < 0.05). After treatment, there were statistically significant increases in both ACh and NO levels, whereas decreases occurred in AChE, ET-1, β2-MG, VILIP-1, and GFAP, levels and the PI and RI of the left-ACA, right-ACA, left-MCA, right-MCA, left-PCA, and right-PCA. The study group showed greater gains in all metrics than the control group (P < 0.05).

Conclusion: EECP combined with atorvastatin is effective in the treatment of cognitive impairment after stroke and can effectively improve the cognitive function, neurotransmitter levels, and brain tissue damage status of patients.

Keywords: Atorvastatin; Brain tissue damage status; Cognitive impairment after stroke; Enhanced extracorporeal counterpulsation; Neurotransmitters.

Figure 1

Comparison of the level of each observation index between the two groups. A: Comparison of neurotransmitter levels between the two groups; B: Comparison of neurotransmitter levels between the two groups; C: Comparison of vascular endothelial function markers between the two groups; D: Evaluation of serum levels of β2-microglobulin, visinin-like protein 1, and glial fibrillary acidic protein between the two groups; E: Comparison of pulsatility index values of the cerebral vasculature between the two groups; F: Analyzing the difference in resistance index values of the cerebral vessels between the two groups. MMSE: Mini-Mental State Examination; MoCA: Montreal Cognitive Assessment; ADL: Activities of daily living; Ach: Acetylcholine; AChE: Acetylcholinesterase; NO: Nitric oxide; ET-1: Endothelin-1; β2-MG: β2-microglobulin; GFAP: Glial fibrillary acidic protein; VILIP-1: Visinin-like protein 1; LACA: Left-anterior cerebral artery; RACA: Right-anterior cerebral artery; LMCA: Left-middle cerebral artery; RMCA: Right-middle cerebral artery; LPCA: Left-posterior cerebral artery; RPCA: Right-posterior cerebral artery. ^aP < 0.05.