Post-stroke cognitive impairment - A cross-sectional comparison study between mild cognitive impairment of vascular and non-vascular etiology.
OBJECTIVE
To elucidate the cognitive profiles of post-stroke vascular mild cognitive impairment (VaMCI) in comparison to MCI of non-vascular etiology and cognitively normal healthy controls at a tertiary-care hospital in southern India.


RESULTS
Logistic regression analysis adjusted for age and sex comparing VaMCI [N=50] with controls [N=27] revealed significant impairment in visual, verbal learning-recall and executive function scores. As compared to the MCI group [N=36], VaMCI had significantly higher scores on Weschler's Memory Scale (WMS) verbal subset delayed recall scores (p=0.045, odds ratio [OR]=2.62, 95% CI=1.02-6.76) with lower scores on WMS-visual immediate learning scores (p=0.042, OR=0.35, 95% CI=0.13-0.96), Rey Auditory Verbal Learning Test (RAVLT) total learning scores (p=0.001, OR=0.17, 95% CI=0.06-0.48) and 20 minute recall (p=0.026, OR=0.33, 95% CI=0.12-0.88), Delayed Matching to Sample test (DMS-48) abstract immediate (p=0.002, OR=0.20, 95% CI=0.07-0.56), abstract delayed recognition sub-sets (p=0.014, OR=0.28, 95% CI=0.10-0.78) and made more total errors on Wisconsin Card Sorting Test (WCST; p=0.040, OR=2.70, 95% CI=1.05-7.14) while the MCI group significantly had more commission errors on RAVLT (p≤0.001, OR=0.13, 95% CI=0.05-0.38) and WCST - perseverative errors (p=0.036, OR=0.30, 95% CI=0.10-0.93). Significant differences were noted in word-list learning-recall (p=0.012) and WMS verbal delayed recall (p=0.014) between VaMCI with mild versus moderate to severe deep white matter hyperintensities on neuroimaging.


CONCLUSIONS
Cognitive impairment following minor stroke involves episodic verbal and visual memory over and above executive function in comparison to MCI of non-vascular etiology. Close cognitive followup is warranted with adequate risk stratification and management especially in the presence of sub-cortical leukoaraiosis which is contributory to cognitive decline in this group of patients.
Cognition and Behavioural Neurology Section, Department of Neurology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
K P
KP
Divya
Cognition and Behavioural Neurology Section, Department of Neurology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India. Electronic address: rsnmenon@sctimst.ac.in.
Ramshekhar N
RN
Menon
Department of Biostatistics, Sree ChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
Ravi Prasad
RP
Varma
Comprehensive Stroke Care Centre, Department of Neurology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
P N
PN
Sylaja
Department of Imaging Sciences and Interventional Radiology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
Bejoy
B
Thomas
Department of Imaging Sciences and Interventional Radiology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
C
C
Kesavadas
Cognition and Behavioural Neurology Section, Department of Neurology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
J
J
Sunitha
Cognition and Behavioural Neurology Section, Department of Neurology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
V S
VS
Lekha
Cognition and Behavioural Neurology Section, Department of Neurology, SreeChitraTirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
S
S
Deepak
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D014706:Verbal Learning / Q000502:physiology
Mild cognitive impairment; Minor stroke; Neuropsychology; Vascular cognitive impairment