Only White Matter Hyperintensities Predicts Post-Stroke Cognitive Performances among Cerebral Small Vessel Disease Markers: Results from the TABASCO Study

Background: White matter hyperintensities (WMH) were shown to predict cognitive decline following stroke or transient ischemic attack (TIA). However, WMH are only one among other radiological markers of cerebral small vessel disease (SVD). Objective: The aim of this study was to determine whether adding other SVD markers to WMH improves prediction of post-stroke cognitive performances. Methods: Consecutive first-ever stroke or TIA patients (n=266) from the Tel Aviv Acute Brain Stroke Cohort (TABASCO) study were enrolled. MRI scans were performed within seven days of stroke onset. We evaluated the relationship between cognitive performances one year following stroke, and previously suggested total SVD burden score including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS). Results: Significant negative associations were found between WMH and cognition (p<0.05). Adding other SVD markers (lacunes, CMB, PVS) to WMH did not improve predication of post-stroke cognitive performances. Negative correlations between SVD burden score and cognitive scores were observed for global cognitive, memory, and visual spatial scores (all p<0.05). However, following an adjustment for confounders, no associations remained significant. Conclusion: WMH score was associated with poor post-stroke cognitive performance. Adding other SVD markers or SVD burden score, however, did not improve prediction.