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Updated: Mar 31, 2026
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
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Lacune-associated cerebral hypoperfusion correlates with cognitive testing.
K Obara1, J S Meyer, K Muramatsu
1From the Cerebrovascular Research Laboratories, Department of Veterans Affairs Medical Center, and Department of Neurology, Baylor College of Medicine, Houston, TX, U.S.A.
Summary
Cerebral hypoperfusion, particularly in frontal white matter, is linked to cognitive impairments in patients with multiple lacunar infarctions. Hypertension and diabetes are key risk factors for this condition.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Multiple lacunar infarctions are associated with cognitive decline.
- Cerebral hypoperfusion is a potential contributing factor to cognitive impairment in this population.
Purpose of the Study:
- To investigate the correlation between cerebral hypoperfusion and cognitive impairments in patients with multiple lacunar infarctions.
- To identify risk factors associated with cognitive decline in this patient group.
Main Methods:
- 83 patients with multiple lacunar infarctions were divided into cognitively impaired (n=40) and intact (n=43) groups based on CCSE scores.
- Plain computed tomography (CT) measured gray and white matter densities.
- Compartmental perfusions were estimated using stable xenon inhalation.
Main Results:
- Cognitive impairments correlated with lacunar infarct multiplicity/bilaterality, hypertension, diabetes mellitus, multiple stroke risk factors, white and gray matter hypoperfusion (especially frontal white matter), leuko-araiosis, aging, and lower education.
- 80 infarcts were detected in the impaired group, versus 62 in the intact group.
Conclusions:
- Hypertension and diabetes mellitus are significant risk factors for cerebral small vessel disease, leading to lacunar infarcts, leuko-araiosis, and hypoperfusion.
- These vascular changes contribute to impaired cognitive function in patients with multiple lacunar infarctions.
