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Frontal systems impairment following multiple lacunar infarcts
N Wolfe1, R Linn, V L Babikian
1Department of Neurology, Boston University School of Medicine, MA.
Archives of Neurology
|February 1, 1990
Summary
Multiple subcortical lacunar infarcts cause cognitive impairments, particularly frontal system dysfunction, even without dementia. These findings suggest a spectrum of cognitive deficits in lacunar states.
Area of Science:
- Neurology
- Neuropsychology
- Gerontology
Background:
- Subcortical lacunar infarcts are small strokes affecting deep brain structures.
- Cognitive impairment is a known complication of cerebrovascular disease.
- The specific cognitive profile following multiple lacunes requires further characterization.
Purpose of the Study:
- To investigate cognitive impairments in individuals with multiple subcortical lacunar infarcts.
- To compare neuropsychological performance between patients with multiple lacunes and healthy controls.
- To explore the relationship between lacunar infarcts and frontal system dysfunction.
Main Methods:
- Prospective study comparing 11 subjects with multiple lacunes to 11 matched controls.
- Neuropsychological testing to assess cognitive functions.
- Behavioral rating scales to evaluate apathy.
Main Results:
- Subjects with multiple lacunes showed significant deficits in executive functions, including mental set shifting and response inhibition.
- Frontal system dysfunction was evident in the lacunar group, despite only 27% meeting dementia criteria.
- Apathy was more frequently observed in the multiple lacunes group.
Conclusions:
- Multiple subcortical lacunar infarcts are associated with distinct patterns of cognitive impairment, primarily affecting frontal systems.
- A continuum of cognitive deficits, from frontal system impairment to dementia, may exist in lacunar states.
- These findings highlight the importance of neuropsychological assessment in patients with lacunar infarcts.