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Updated: Apr 9, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebral Microbleeds and Cognitive Function in Ischemic Stroke or Transient Ischemic Attack Patients
Zhaolu Wang1, Adrian Wong, Wenyan Liu
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Background:
We explored the association between cerebral microbleeds (CMBs) and cognitive impairment in patients with ischemic stroke/transient ischemic attack (TIA).
Methods:
A total of 488 ischemic stroke/TIA patients received magnetic resonance imaging. Montreal Cognitive Assessment (MoCA) was used to evaluate global cognitive function and cognitive domains. The association of CMB quantity with cognitive function and the impact of CMB locations (strictly lobar, strictly deep, and mixed regions) on cognitive impairment were examined in regression models with adjustments for confounders.
Results:
A total of 113 subjects (23.2%) had ≥1 CMB. Strictly lobar, strictly deep, and mixed CMBs were identified in 36, 40, and 37 patients, respectively. The presence of ≥5 CMBs or strictly deep CMBs was associated with the MoCA total score (p = 0.007 and 0.020, respectively). Of all MoCA domains tested, a lower score in the attention domain was related to the presence of ≥5 CMBs (p = 0.014) and strictly deep CMBs (p = 0.028).
Conclusion:
CMBs were associated with cognitive dysfunction in stroke/TIA patients, especially in the attention domain. This association was mainly driven by CMBs in the deep region, underlining the role of hypertensive microangiopathy in stroke-related cognitive impairment.
Insights
Cerebral microbleeds (CMBs) are linked to cognitive impairment in stroke patients, particularly affecting attention. Deep CMBs are strongly associated with this cognitive decline, highlighting their role in stroke-related cognitive issues.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Cerebral microbleeds (CMBs) are increasingly recognized as a marker of cerebrovascular disease.
- Their association with cognitive impairment in patients with ischemic stroke or transient ischemic attack (TIA) warrants further investigation.
Purpose of the Study:
- To investigate the relationship between the quantity and location of CMBs and cognitive function in ischemic stroke/TIA patients.
- To determine the impact of CMBs on global cognitive function and specific cognitive domains, such as attention.
Main Methods:
- Magnetic resonance imaging (MRI) was performed on 488 ischemic stroke/TIA patients.
- Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), evaluating both global cognition and specific domains.
- Regression models, adjusted for confounders, were used to analyze the association between CMBs (quantity and location) and cognitive outcomes.
Main Results:
- 23.2% of patients (113/488) had at least one CMB.
- The presence of 5 or more CMBs, or strictly deep CMBs, was significantly associated with lower MoCA total scores (p=0.007 and p=0.020, respectively).
- Lower scores in the attention domain were linked to the presence of 5 or more CMBs (p=0.014) and strictly deep CMBs (p=0.028).
Conclusions:
- CMBs are associated with cognitive dysfunction in patients following ischemic stroke or TIA.
- This association is particularly evident in the attention domain and is predominantly driven by CMBs located in deep brain regions.
- These findings underscore the contribution of hypertensive microangiopathy to cognitive impairment in the context of stroke.
