Neuroimaging determinants of cognitive performances in stroke associated with small vessel disease.
OBJECTIVE
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.
Mok
V
V
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. vctmok@cuhk.edu.hk
Chang
Carlin
C
Wong
A
A
Lam
W W M
WW
Richards
Polly S
PS
Wong
K T
KT
Wong
Ka Sing
KS
D000367:Age Factors; D000368:Aged; D001284:Atrophy; D020520:Brain Infarction / Q000503:physiopathology; D002539:Cerebral Arterial Diseases / Q000150:complications*; D002540:Cerebral Cortex / Q000473:pathology; D003071:Cognition / Q000502:physiology*; D003704:Dementia / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D004522:Educational Status; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D020521:Stroke / Q000473:pathology / Q000503:physiopathology*; D013702:Temporal Lobe / Q000473:pathology; D013788:Thalamus / Q000098:blood supply; D014057:Tomography, X-Ray Computed