Lobar microbleeds are associated with cognitive impairment in patients with lacunar infarction

Area of Science:

• Neurology
• Radiology
• Cognitive Science

Background:

• Cerebral microbleeds (CMBs) are increasingly recognized in relation to cognitive decline.
• Previous studies on the association between CMB distribution and cognitive function have yielded controversial results.
• Understanding these associations is crucial for managing patients with cerebrovascular diseases.

Purpose of the Study:

• To investigate the relationship between magnetic resonance imaging (MRI) findings, specifically CMBs, and cognitive function in patients experiencing their first lacunar infarction.
• To determine if the location (lobar vs. deep) of CMBs influences cognitive status.

Main Methods:

• Retrospective analysis of 273 patients with first-ever lacunar infarction confirmed by MRI.
• Exclusion of patients with pre-existing dementia.
• Cognitive function assessed using the Mini-Mental State Examination (MMSE) within 3 days of admission.

Main Results:

• The median MMSE score was 27.
• Univariate analysis showed associations between MMSE scores and age, BMI, education, dyslipidemia, CKD, periventricular hyperintensity, medial temporal atrophy, and CMB distribution (lobar and mixed).
• Multivariate analysis revealed that lobar CMBs (p < 0.001) and mixed CMBs (p = 0.008) were independently associated with lower MMSE scores, suggesting cognitive impairment.

Conclusions:

• Lobar cerebral microbleeds are independently associated with cognitive impairment in patients with first-ever lacunar infarction.
• The distribution of CMBs, particularly in lobar regions, is a significant factor in cognitive decline following lacunar stroke.
• These findings highlight the importance of identifying CMB patterns on MRI for assessing cognitive risk in stroke patients.