MRI Predictors of Cognitive Function After Lacunar Infarction

Area of Science:

• Neurology
• Radiology
• Neuroscience

Background:

• Poststroke cognitive impairment significantly impacts disability and quality of life.
• Lacunar infarction (LACI) is a common cause of stroke, often leading to cognitive deficits.
• Identifying predictive biomarkers for cognitive impairment after LACI is crucial for patient management.

Purpose of the Study:

• To evaluate the predictive value of individual and collective magnetic resonance imaging (MRI) biomarkers for cognitive impairment following LACI.
• To determine if specific MRI findings can forecast the development or severity of cognitive decline after LACI.

Main Methods:

• Retrospective analysis of 134 patients with acute LACI from the American Stroke Association Bugher Small Vessel Study.
• Assessed MRI biomarkers included: number/size of lacunes, ventricular size, cerebral atrophy, lesion location, and white matter disease (WMD) extent.
• Cognitive function assessed using the Montreal Cognitive Assessment (global cognition) and Trail Making Test Part B (executive function). Regression analyses were employed.

Main Results:

• No significant associations were found between MRI characteristics and global cognition (Montreal Cognitive Assessment).
• Cerebral atrophy, ventricular size, and WMD extent were initially associated with longer Trail Making Test Part B completion times (executive function).
• After multivariable adjustment, only the extent of white matter disease (WMD) remained significantly associated with executive function impairment.

Conclusions:

• The extent of white matter disease (WMD) on MRI is the sole independent predictor of executive function deficits after lacunar infarction.
• WMD may represent a critical imaging biomarker for identifying LACI patients at higher risk of cognitive impairment, specifically affecting executive functions.