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Updated: Mar 8, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Only White Matter Hyperintensities Predicts Post-Stroke Cognitive Performances Among Cerebral Small Vessel Disease
Jeremy Molad1, Efrat Kliper1,2,3, Amos D Korczyn1,2
1Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Background:
White matter hyperintensities (WMH) were shown to predict cognitive decline following stroke or transient ischemic attack (TIA). However, WMH are only one among other radiological markers of cerebral small vessel disease (SVD).
Objective:
The aim of this study was to determine whether adding other SVD markers to WMH improves prediction of post-stroke cognitive performances.
Methods:
Consecutive first-ever stroke or TIA patients (n = 266) from the Tel Aviv Acute Brain Stroke Cohort (TABASCO) study were enrolled. MRI scans were performed within seven days of stroke onset. We evaluated the relationship between cognitive performances one year following stroke, and previously suggested total SVD burden score including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS).
Results:
Significant negative associations were found between WMH and cognition (p < 0.05). Adding other SVD markers (lacunes, CMB, PVS) to WMH did not improve predication of post-stroke cognitive performances. Negative correlations between SVD burden score and cognitive scores were observed for global cognitive, memory, and visual spatial scores (all p < 0.05). However, following an adjustment for confounders, no associations remained significant.
Conclusion:
WMH score was associated with poor post-stroke cognitive performance. Adding other SVD markers or SVD burden score, however, did not improve prediction.
Insights
White matter hyperintensities (WMH) predict cognitive decline after stroke. However, adding other small vessel disease (SVD) markers did not improve this prediction of post-stroke cognitive performance.
Area of Science:
- Neurology
- Radiology
- Cognitive Science
Background:
- White matter hyperintensities (WMH) are known predictors of cognitive decline post-stroke or transient ischemic attack (TIA).
- WMH are one of several radiological markers of cerebral small vessel disease (SVD).
Purpose of the Study:
- To investigate if incorporating additional SVD markers alongside WMH enhances the prediction of cognitive performance after stroke.
- To assess the predictive value of a comprehensive SVD burden score for post-stroke cognition.
Main Methods:
- The study included 266 patients with first-ever stroke or TIA from the Tel Aviv Acute Brain Stroke Cohort (TABASCO).
- MRI scans were conducted within seven days of stroke onset.
- Cognitive performance one year post-stroke was evaluated against SVD markers including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS).
Main Results:
- Significant negative associations were observed between WMH and cognitive function (p < 0.05).
- Including other SVD markers (lacunes, CMB, PVS) with WMH did not improve the prediction of post-stroke cognitive performance.
- While initial correlations indicated negative associations between SVD burden score and global cognitive, memory, and visual-spatial scores, these did not remain significant after adjusting for confounders.
Conclusions:
- WMH scores are associated with poorer cognitive outcomes after stroke.
- The addition of other SVD markers or a total SVD burden score did not enhance the predictive capability for post-stroke cognitive performance.
