Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up...

Area of Science:

• Neurology
• Neuroimaging
• Cognitive Science

Background:

• Stroke is a leading cause of disability, often leading to cognitive dysfunction.
• Small vessel disease (SVD) is common in stroke patients and may contribute to cognitive impairment.
• Understanding the relationship between SVD burden and cognitive outcomes is crucial for patient management.

Purpose of the Study:

• To investigate the association between the overall burden of small vessel disease (SVD) and cognitive dysfunction in patients following acute ischemic stroke.
• To identify specific SVD markers that are most strongly associated with cognitive decline.

Main Methods:

• 451 patients with first-ever acute ischemic stroke were assessed.
• Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) at multiple time points.
• SVD burden was quantified by summing scores of four MRI markers: white matter hyperintensities (WMHs), lacunes, cerebral microbleeds, and perivascular spaces.

Main Results:

• Cognitive impairment was observed in approximately one-third of patients.
• A higher SVD burden was significantly associated with lower MMSE scores (β = -0.37, P = .003) and increased odds of cognitive impairment (OR = 1.20, 95% CI = 1.02-1.42).
• White matter hyperintensities (WMHs) were the most significant predictor of decreased MMSE scores and cognitive impairment.

Conclusions:

• Cerebral SVD burden is associated with cognitive dysfunction in the first year after mild-to-moderate acute ischemic stroke.
• These findings highlight the importance of assessing SVD burden in post-stroke cognitive evaluation and management.