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Cognitive impact of lacunar infarcts and white matter hyperintensity volume
Matthew W Warren1, Myron F Weiner2, Heidi C Rossetti2
1University of South Florida, Tampa, Fla., USA.
Insights
Lacunar infarcts, small strokes in the brain, are linked to lower cognitive function in adults over 55. More lacunes correlated with poorer scores on memory, attention, and executive function tests.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Subcortical lacunar infarcts and white matter hyperintensities (WMH) are common in aging brains.
- Limited research connects these brain changes to cognitive decline in community-dwelling populations.
Purpose of the Study:
- To investigate the association between lacunar infarcts, WMH, and cognitive performance.
- To analyze cognitive domains including memory, executive function, and attention.
Main Methods:
- Utilized data from the Dallas Heart Study, including brain MRI and Montreal Cognitive Assessment (MoCA).
- Assessed lacunar infarct presence and number, and WMH volume in 609 subjects aged over 55.
- Employed linear regression to analyze associations, adjusting for demographic factors.
Main Results:
- The presence and number of lacunar infarcts were significantly associated with lower overall MoCA scores.
- Lacunes correlated with reduced scores in memory, executive function, and attention subdomains.
- WMH volume did not show a significant association with MoCA scores.
Conclusions:
- Midlife lacunar infarcts are linked to diminished cognitive performance across multiple domains.
- Cognitive screening measures like MoCA can detect deficits associated with lacunar infarcts.
Background:
Subcortical lacunar infarcts and white matter hyperintensities (WMH) are common neuroradiological findings, but few studies associate between these insults and cognition in a community-dwelling population.
Methods:
The Dallas Heart Study is a population-based initiative whose assessments included demographic and clinical findings including brain MRI and the Montreal Cognitive Assessment (MoCA). The presence and number of lacunes in subjects aged over 55 years were assessed by study physicians. The WMH volume was measured by an automated method. The association between the presence and number of lacunar infarcts and of WMH volume with the total MoCA score and subdomains was assessed using linear regression with adjustment for age, gender and self-reported ethnicity.
Results:
In 609 subjects with valid data, both the presence and the increasing number of lacunes were associated with lower MoCA scores, even after adjusting for demographic variables. The presence of lacunes was also associated with lower scores in the memory, executive and attention subdomains. The WMH volume was not significantly associated with the MoCA score.
Conclusion:
The presence and increasing number of lacunes in midlife is associated with a lower performance in multiple domains of a cognitive screening measure after adjusting for demographic factors.
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