Correlation between white matter lesions and cognitive impairment after stroke

Introduction :To investigate the correlation between white matter lesions (WML) and vascular cognitive impairment in patients with acute ischemic stroke. Materials and Methods :120 patients (79 males, 41 females, average age 65.63±10.12 years) with acute ischemic stroke hospitalized in the Department of Neurology of Mianyang City Central Hospital from February to November 2019 were collected,and collect general information such as patient age, hypertension, and diabetes.All patients underwent a complete cranial MRI, and the white matter lesions were scored on the Fazekas Scale, which were divided into mild WML group (1 - 3 points)(67 cases) and severe WML group (4 - 6 points)(53 cases). The WML volume of the enrolled patients was calculated by semi-automatic measurement software 3Dslicer.All enrolled patients completed the clinical dementia assessment (CDR) scale endpoint scores at 90 days and 1 year after onset; the difference in CDR endpoint scores between the two groups was compared using a chi-square test. Spearman correlation analysis was used to test the correlation between CDR endpoint scores and white matter lesion volume and ischemic stroke site. Results :The probabilities of suspected dementia and dementia in acute ischemic stroke patients with severe WML group 1 year after onset were (58.49%(31/53) and 35.85%(19/53)) were higher than those in mild WML group, respectively (52.24%(35/67), 25.37%(17/67)), while the proportion of patients without cognitive impairment in the mild WML group (22.39%(15/67)) was significantly higher than that of severe WML group (5.66%(3/53)), with statistical differences (P<0.05);WML volume was positively correlated with the CDR endpoint scores at 90 days after onset and 1 year in patients with ischemic stroke (R= 0.20, P =0.027;R= 0.21, P =0.022). Conclusion : The severity of WML in patients with acute cerebral infarction is an important factor affecting cognitive impairment after stroke.