Effects Of Lacunar Infarcts And White Matter Lesions On Cognitive Function

Background and objectives:Cerebral small vessel disease (SVD) consists of a series of diseases that affect the small arteries, arterioles and venules. It causes one quarter of all ischemic stroke, and it is even the most frequent cause of vascular dementia.The most common forms of SVD are lacunar infarcts and white matter lesions (WML), as they were easily seen in neuroimaging. Recently, the association between lacunar infarcts/matter lesions and cognitive function was studied. Accumulated evidence suggested that lacunar infarcts/matter lesions were associated with cognitive impairment, such as, psychomotor retardation and dysexecutive function. It was a long and progressive course for SVD leading to dysfunction of cognition. However, the respective role of lacunes and WML on cognition is still conflictive, especially the role of lacunar infarcts on cognitive impairment. The purpose of this study is to assess their respective effects on cognitive impairment, including the effects of the location of lacunes.Methods:Participants:All data of the participants was drawn from the inpatients in Department of Neurology of Shandong Qianfoshan Hospital from the June of 2010 to the February of 2011, age between 45 and 80 years old. We excluded the patients whose cranial large vessel had stenosis or occlusion in MRA, and combined with other serious diseases.The scores for general, executive, memory and verbal fluency performed by MMSE, CDT and MoCA three neuropsychological scales. All participants received MRI and MRA scanning. Grade of WML, and number or location of lacunes were recorded on the basis of brain MRI, we also record the patients'history disease. We used multivariate linear regression analysis adjusted for all other vascular risk factors.Results:1. the associations between WML and MMSE,CDT,MoCAthe presence of WML was associated with decreased MMSE and CDT scores independently (p=0.039 and p=0.034),2. the associations between location of lacunes and executive function, memory function, verbal fluency function(1)lacunar infarct located in cortical or juxtcortical was related to the impairment of executive function (p=0.079).(2)lacunar infarcts in basal ganglia was related to the impairment of verbal fluency (p=0.052).Conclusion:WML and lacunar infarcts are independently impair cognitive function, and different dysfunction of cognition is related to different location of lacunes.