Related Experiment Video
Updated: Mar 13, 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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White matter hyperintensity volume predicts persistent cognitive impairment in transient ischemic attack and minor
Leka Sivakumar1, Parnian Riaz1, Mahesh Kate1
11 Division of Neurology, University of Alberta, Alberta, Canada.
Summary
Persistent cognitive deficits after minor stroke are linked to chronic white matter changes, not acute lesions. Most patients recover cognitive function within 30 days, but underlying white matter integrity influences long-term outcomes.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Cognitive changes after transient ischemic attack (TIA) or minor stroke are known.
- The correlation between acute infarction on MRI and persistent cognitive deficits remains unclear.
Purpose of the Study:
- To test if diffusion-weighted imaging (DWI) lesion volume predicts persistent cognitive impairment after TIA/minor stroke.
- To investigate the relationship between acute infarcts and long-term cognitive function.
Main Methods:
- Prospective recruitment of TIA/minor stroke patients (NIH stroke scale ≤3) within 72 hours.
- Baseline and follow-up cognitive assessments (Montreal Cognitive Assessment) and MRI (DWI, FLAIR) at days 7 and 30, with cognitive testing repeated at day 90.
- Planimetric measurement of DWI lesion and FLAIR white matter hyperintensity volumes.
Main Results:
- 91 out of 115 patients (79%) had acute ischemic lesions.
- Cognitive impairment rates were similar in patients with and without acute DWI lesions (52% vs. 54%, p=0.83).
- Acute DWI lesion volume did not predict 30-day cognitive scores (β=-0.163, p=0.144), but baseline white matter hyperintensity volume predicted persistent deficits (β=2.24, p=0.005).
Conclusions:
- Most acute cognitive impairment after TIA/minor stroke is temporary.
- Persistent cognitive deficits after 30 days correlate with chronic white matter hyperintensity.
- This suggests pre-existing subclinical impairment or reduced compensation capacity impacts long-term cognitive outcomes.
