Key result
Brainstem lacunar infarct linked to significantly impaired multi-domain neuropsychological performance vs matched controls.
Why the study?
Subtle cognitive impairments have been observed in patients with small supratentorial white matter infarcts, but the underlying mechanisms and effects of brainstem lacunar infarcts on cognition remain unclear.
Case-Control
Awareness of subtle cognitive effects after small white matter infarcts is warranted; leaves open bystander versus remote mechanisms and requires prospective confirmation.
Earlier findings in patients with a small supratentorial white matter infarct demonstrated subtle impairments of cognition. This is in line with reported difficulties in regaining premorbid level of functioning in daily life activities, even though any physical neurological deficits are no longer present. Either a "bystander effect" of adjoining gray matter or a long distance effect through hypometabolism or other neurochemical changes might underlie these impairments. To find the best explanation, a group of 17 patients with a lacunar infarct in the brainstem was neuropsychologically evaluated and compared with a closely matched control group. The patients demonstrated significantly impaired task performance on a constellation of neuropsychological tasks that was very similar to the findings previously found in patients with a supratentorial lacunar infarct (Boston Naming Test, TEA visual elevator, category fluency, Trailmaking Test). We conclude that a small white-matter infarct may affect cognitive functioning in a nonspecific way independently of its location.
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Zandvoort et al. (2003) conducted a case-control in Lacunar infarct in the brainstem. Lacunar infarct in the brainstem vs. Closely matched control group was evaluated on Task performance on a constellation of neuropsychological tasks (Boston Naming Test, TEA visual elevator, category fluency, Trailmaking Test). A lacunar infarct in the brainstem was associated with significantly impaired performance on a constellation of neuropsychological tasks compared to a matched control group.
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