Cerebral small vessel disease and post-stroke cognitive impairment

Abstract

Cerebral small vessel disease (CSVD) refers to a group of pathological processes with multifarious etiologies that affect the small arteries, arterioles, venules, and capillaries of the brain. Features seen on neuroimaging include white matter hyperintensities, lacunar infarction, cerebral microbleeds, brain atrophy, microinfarcts and enlarged perivascular spaces (EPVS). CSVD gives rise to one in five strokes worldwide and is a leading cause of cognitive impairment and dementia, especially in the elderly. Post-stroke cognitive impairment (PSCI) is one of the most common subtypes of cognitive impairment. The underlying mechanisms of PSCI are not known in detail. A growing body of evidence has been suggesting that CSVD plays an important role in the pathogenesis of PSCI. This article reviews the advances in research on the relationship between CSVD and PSCI.

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment

“…WML is defined as hyperintensities on fluid-attenuated inversion recovery (FLAIR) and proton density/T2-weighted images, without prominent hypointensity on T1-weighted images. [ 5 ] WML refers to the entire spectrum of such lesions from mild perivascular tissue damage surrounding the lipohyalinotic arterioles which result in minimal axonal loss, to more severe ischemic damage, which can cause extensive myelin and axonal loss. [ 6 ]…”

Baseline white matter hyperintensities affect the course of cognitive function after small vessel disease‐related stroke: a prospective observational study

“…The neuroimaging correlate of a lacunar stroke is a recent small subcortical infarct (RSSI) in the supply area of a small perforating brain artery [1,2]. Cognitive impairment is common in lacunar stroke patients and might be worsened by preexisting cerebral small vessel disease (SVD), suggested by magnetic resonance imaging (MRI) via the morphological features lacunes, white matter hyperintensities (WMH), microbleeds, or brain atrophy [3–6], especially concerning gray matter [7,8]. SVD is a leading cause of vascular cognitive impairment and dementia, predominantly affecting the domains executive functions (e.g., set‐shifting, the ability to shift attention between one task and another), attention, memory, processing speed, and verbal fluency [5,6].…”

Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up Study

“…2 Cerebral small vessel disease (SVD) is one of the leading causes of poststroke cognitive impairment. 3 SVD arises from diseases affecting the perforating cerebral vessels that cause brain damage in the white and deep gray matter that eventually present as white matter hyperintensities (WMHs), lacunes, cerebral microbleeds, or enlarged perivascular spaces on magnetic resonance imaging (MRI). 4 Lacunes burden, a composite of several SVD markers, is showed to be better predictor of poststroke depressive symptoms, 5 disability, 6 or recurrence of stroke.…”