Key result
Left frontal atrophy and thalamic lacunae independently predict cognitive impairment in small vessel disease stroke.
Cross-Sectional (n=74)
No
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BACKGROUND AND PURPOSE: Controversies still exist as to the neuroimaging determinants of cognitive impairment in cerebral small vessel disease (SVD). The authors studied the neuroimaging correlates of cognitive performances among patients with stroke associated with SVD. METHODS: The authors per formed cerebral computed tomography, magnetic resonance imaging, and diffusion-weighted imaging among 74 consecutive patients admitted to the acute stroke unit because of stroke associated with SVD. They examined the association between cognitive performances and the following neuroimaging features: volume of white matter changes (WMC), multiplicity of lacunae, location of lacunae, total cerebral atrophy, and frontal and medial temporal lobe atrophy. RESULTS: Apart from age and education, univariate linear regression analyses revealed that WMC volume, presence of thalamic lacunae, cerebral atrophy, and left frontal lobe atrophy predicted performance on the Mini-Mental State Examination while WMC volume, presence of thalamic infarcts, cerebral atrophy, and frontal lobe atrophy of both sides predicted performance on the Mattis Dementia Rating Scale-Initiation/Preservation subscale. In the multivariate analyses, education (R2=0.22, P<.001), left frontal lobe atrophy (R2=0.10, P=.004), and presence of thalamic lacunae (R2=0.04, P=.049) were found to predict performance on the Mini-Mental State Examination while age (R2=0.23, P<.001) and presence of thalamic lacunae (R2=0.08, P=.011) were found to predict performance on the Mattis Dementia Rating Scale-Initiation/Preservation. CONCLUSIONS: Among patients with stroke associated with SVD, thalamic lacunae and frontal lobe atrophy are key determinants of cognitive performances.
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Mok et al. (2005) conducted a cross-sectional in Stroke associated with cerebral small vessel disease (SVD) (n=74). Neuroimaging features (white matter changes volume, lacunae multiplicity and location, cerebral and lobar atrophy) was evaluated on Cognitive performance (Mini-Mental State Examination and Mattis Dementia Rating Scale-Initiation/Preservation subscale) (R2 0.10 (left frontal lobe atrophy on MMSE); R2 0.04 (thalamic lacunae on MMSE); R2 0.08 (thalamic lacunae on MDRS-I/P), p=.004 (left frontal atrophy on MMSE); .049 (thalamic lacunae on MMSE); .011 (thalamic lacunae on MDRS-I/P)). Left frontal lobe atrophy (R2=0.10, P=.004) and thalamic lacunae (R2=0.04, P=.049) independently predicted cognitive performance on the MMSE in patients with small vessel disease stroke.
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