Lacunar Infarcts, but Not Perivascular Spaces, Are Predictors of Cognitive Decline in Cerebral Small-Vessel Disease

• DOI: 10.1161/strokeaha.117.017526
• Publication Date: 2018-02-02T10:05:09Z
• Authors: Philip Benjamin; Sarah Trippier; Andrew J. Lawrence; Christian Lambert; Eva Zeestraten; Owen A. Williams; Bhavini Patel; Robin G. Morris; Thomas R. Barrick; Andrew D. MacKinnon; Hugh S. Markus
• Keywords: Perivascular space; Lacunar stroke; Cognitive Decline; Leukoaraiosis; Stroke; Lacunar infarction

Background and Purpose— Cerebral small-vessel disease is a major cause of cognitive impairment. Perivascular spaces (PvS) occur in disease, but their relationship to impairment remains uncertain. One reason may be difficulty distinguishing between lacunes PvS. We determined the baseline PvS score volume with change cognition over 5-year follow-up. compared this lacune count total cognition. In addition, we examined time. Methods— Data from prospective SCANS study (St Georges Cognition Neuroimaging Stroke) patients symptomatic lacunar stroke confluent leukoaraiosis were used (n=121). Multimodal magnetic resonance imaging was performed annually for 3 years neuropsychological testing 5 years. Lacunes manually identified distinguished rated using validated visual rating scale, volumes calculated T1-weighted images. Linear mixed-effect models determine impact on Results— Baseline scores or showed no association indices. No detectable contrast, associated all indices predicted decline Conclusions— Although feature are not predictor decline, contrast lacunes. This highlights importance carefully differentiating studies investigating vascular