Asymptomatic cerebral small infarcts (lacunae), their risk factors and intellectual disturbances

This study examines the relationship between cerebral small infarcts (lacunae) and the multiple risk factors of diabetes, age, hypertension, hyperlipidemia, and atherosclerosis in asymptomatic NIDDM patients and nondiabetic subjects by comparing brain magnetic resonance imaging (MRI) findings to these risk factors. Brain MRI was performed on 155 asymptomatic NIDDM and 39 asymptomatic nondiabetic patients, using a Shimazu SMT-150, 1.5-T instrument. Among the diabetic patients, 65 showed evidence of lacunae. The incidence of lacunae was significantly higher in older diabetic patients, but it did not significantly differ in those with or without the risk factors of atherosclerosis. We also correlated the results of a freehand cube-drawing test with the incidence of lacunae. Cube-drawing is a good indicator of spatial cognition ability supported by wide association areas of the brain. Drawing ability was tested in 56 diabetic and 39 nondiabetic subjects. Correlations of lacuna incidence with deformity in drawing and with age were high in the diabetic group. Correlation of lacunae with deformity in drawing was also significant in nondiabetic subjects. The incidence of lacunae was highly correlated with intellectual impairment.