Cognitive Impairment After Minor Stroke: Exploring Prevalence and Associations With WMH, Stroke Location, and Subtype

IF 1.1 3区医学 Q2 CLINICAL NEUROLOGY Acta Neurologica Scandinavica Pub Date : 2026-09-28 DOI:10.1155/ane/5290808

Vera Solianik, Åse Hagen Morsund, Magnus Tallaksen Reiestad, Halvor Næss, Rune Midgard, Ramune Grambaite

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Abstract

Objective

This study is aimed at examining the prevalence of cognitive impairment following minor stroke and its associations with stroke subtype, location, and pre-existing vascular pathology.

Material and Methods

We included 305 patients from stroke units at the Central Norway Health Trust and from Haukeland University Hospital. MRI was performed using 1.5-T scanners as part of the routine stroke protocol during hospitalization at stroke units at baseline. Minor stroke was classified according to NIHSS 0–7 and mRS 0–2. We registered left versus right hemispheric location as well as Fazekas classification of pre-existing white matter hyperintensities (WMHs). Study patients underwent cognitive assessment 3 months after the stroke using a wide range of neuropsychological tests. Cognitive impairment was defined as performance 1.5 SD below the norm-based average on ≥ 2 tests. Chi-square and regression analyses were conducted to consider the associations between cognitive impairment and WMH and infarction subtype and location.

Results

78.4% of participants had impaired results on at least one test, and 62% had impaired results on ≥ 2 tests. WMH and several infarction locations were associated with impaired cognitive performance in the initial analyses, but only the association between supratentorial infarctions and impaired memory recall remained significant after Benjamini–Hochberg correction. Higher education was associated with lower risk of impaired cognitive performance.

Conclusions

Our findings showed a high prevalence of cognitive impairment 3 months after minor stroke in a younger cohort, largely irrespective of stroke location and subtype. Such substantial cognitive burden should be taken into consideration during clinical stroke assessment, while also accounting for demographic variables such as education. In future research, longer follow-up periods may provide a more nuanced understanding of the trajectory of cognitive impairment after minor stroke.

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轻度脑卒中后认知障碍：探讨WMH、脑卒中部位和亚型的患病率及其相关性

目的本研究旨在探讨轻度脑卒中后认知功能障碍的患病率及其与脑卒中亚型、部位和既往血管病理的关系。材料和方法我们纳入了来自中挪威卫生信托和豪克兰大学医院中风病房的305例患者。在基线中风单位住院期间，使用1.5 t扫描仪作为常规中风方案的一部分进行MRI。轻度中风按NIHSS 0-7分，mRS 0-2分。我们记录了左半球和右半球的位置以及预先存在的白质高强度（WMHs）的Fazekas分类。研究患者在中风后3个月通过广泛的神经心理学测试进行认知评估。认知障碍定义为在≥2次测试中表现低于标准平均1.5 SD。通过卡方分析和回归分析来考虑认知障碍与WMH、梗死亚型和部位之间的关系。结果78.4%的参与者在至少一项测试中有不良结果，62%的参与者在≥2项测试中有不良结果。在最初的分析中，WMH和一些梗死部位与认知能力受损有关，但在benjamin - hochberg校正后，只有幕上梗死和记忆回忆受损之间的关联仍然显著。高等教育与认知能力受损的风险较低有关。结论：我们的研究结果显示，在一个年轻的队列中，轻微中风后3个月认知功能障碍的患病率很高，很大程度上与中风的位置和亚型无关。在临床卒中评估中应考虑到这种巨大的认知负担，同时也考虑到教育等人口统计学变量。在未来的研究中，更长的随访期可能会对轻度中风后认知障碍的发展轨迹提供更细致的了解。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.