Post-stroke subjective cognitive impairment is associated with acute lacunar infarcts in the basal ganglia

While recent studies have examined neuroimaging correlates of post-stroke mild cognitive impairment (MCI), no studies have examined neuroimaging correlates of post-stroke subjective cognitive impairment (SCI).

Consecutive patients with magnetic resonance imaging-confirmed acute lacunar strokes at a tertiary institute were recruited for this cross-sectional study. All patients underwent cognitive testing, and those with MCI were excluded from these analyses. Two independent neuroradiologists ascertained data on the number and location of any infarcts, as well as the degree of white matter hyperintensities. Multivariate logistic regression analyses were performed to study the association between neuroimaging markers and SCI. Only variables that were significant in the univariate stage and clinically relevant potential confounders were included in multivariable analyses.

Of 145 patients evaluated, 48 patients with MCI were excluded from the study. Of the remaining 97 patients, 30 patients had SCI. In multivariable analyses, only mini-mental state examination (OR 0.61; CI 0.38-0.98) and basal ganglia infarcts (OR 8.19; CI 1.18-56.6) were significant predictors of SCI.

In patients with acute lacunar strokes, we find that basal ganglia infarcts are associated with SCI. As the basal ganglia have been previously shown to be involved with learning of tasks, we hypothesize that infarcts in basal ganglia may affect learning speeds thereby contributing to the development of SCI. Larger studies are needed to confirm these results.