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Updated: Oct 11, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Imaging Markers of Subcortical Vascular Dementia in Patients With Multiple-Lobar Cerebral Microbleeds
Chia-Yen Lin1, Song-Ru Jhan2, Wei-Ju Lee1,3,4
1Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.
Insights
Small vessel disease (SVD) imaging markers, including white matter hyperintensities and cerebral microbleeds, are linked to dementia. These markers may aid personalized treatment for cognitive impairment in patients with significant SVD burden.
Area of Science:
- Neurology
- Radiology
- Gerontology
Background:
- Small vessel disease (SVD) is associated with stroke and cognitive decline.
- Imaging markers of SVD are crucial for understanding neurological conditions.
Purpose of the Study:
- To investigate the relationship between SVD imaging markers and subcortical vascular dementia.
- To analyze these associations in individuals with a substantial SVD burden.
Main Methods:
- 57 subjects with multiple lobar cerebral microbleeds (CMBs) and SVD markers were analyzed.
- Visual rating scales quantified SVD changes, correlating them with cognitive domains and dementia.
- Multivariate logistic regression adjusted for demographic factors.
Main Results:
- The dementia group exhibited higher white matter hyperintensities (WMHs) and SVD composite scores.
- Individual SVD markers showed distinct correlations with cognitive domains.
- Subcortical WMHs, total WMHs, lacunes, and composite SVD scores were associated with dementia.
Conclusions:
- SVD imaging markers demonstrate varied associations with cognitive function and dementia.
- These markers offer valuable insights for personalized cognitive impairment treatment strategies.
- Identifying SVD burden is key for targeted interventions.
Abstract:
Background and Purpose: Small vessel disease (SVD) imaging markers are related to ischemic and hemorrhage stroke and to cognitive dysfunction. This study aimed to clarify the relationship between SVD imaging markers and subcortical vascular dementia in severe SVD burden. Methods: A total of 57 subjects with multiple lobar cerebral microbleeds (CMBs) and four established SVD imaging markers were enrolled from the dementia and stroke registries of a single center. Visual rating scales that are used to semi-quantify SVD imaging changes were analyzed individually and compositely to make correlations with cognitive domains and subcortical vascular dementia. Results: Dementia group had higher subcortical and total white matter hyperintensities (WMHs) and SVD composite scores than non-dementia group. Individual imaging markers correlated differently with one another and had distinct cognitive correlations. After adjusting for demographic factors, multivariate logistic regression indicated associations of subcortical WMHs (odds ratio [OR] 2.03, CI 1.24-3.32), total WMHs (OR 1.43, CI 1.09-1.89), lacunes (OR 1.18, CI 1.02-1.35), cerebral amyloid angiopathy-SVD scores (OR 2.33, CI 1.01-5.40), C1 scores (imaging composite scores of CMB and WMH) (OR 1.41, CI 1.09-1.83), and C2 scores (imaging composite scores of CMB, WMH, perivascular space, and lacune) (OR 1.38, CI 1.08-1.76) with dementia. Conclusions: SVD imaging markers might have differing associations with cognitive domains and dementia. They may provide valuable complementary information in support of personalized treatment planning against cognitive impairment, particularly in patients with a heavy SVD load.
