Longitudinal white matter hyperintensity changes and cognitive decline in patients with minor stroke

Area of Science:

• Neurology
• Neuroimaging
• Geriatric Medicine

Background:

• Minor stroke and white matter hyperintensities (WMHs) increase dementia risk.
• Factors influencing WMH volume changes and cognitive decline post-stroke are unclear.

Purpose of the Study:

• To investigate factors associated with changes in WMH volume and cognitive decline over 2 years in minor stroke patients.
• To understand the dynamic nature of WMH and its impact on cognition.

Main Methods:

• Longitudinal study of minor ischemic stroke patients over 2 years.
• Multimodal MRI and cognitive assessments (TICS-m) at baseline and follow-up.
• Automated WMH volume measurement using a lesion prediction algorithm.

Main Results:

• WMH volume increased in 113, decreased in 74, and stabilized in 58 patients.
• Hypertension history and higher CSVD burden predicted WMH progression.
• Lacunes were a strong predictor of WMH progression; WMH progression predicted cognitive decline.

Conclusions:

• WMH volume changes dynamically in minor stroke patients.
• Regular antihypertensive medication use correlated with WMH volume reduction.
• WMH progression is a significant predictor of cognitive decline in this population.