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COMPARISON OF VASCULAR COGNITIVE IMPAIRMENT POST-STROKE BETWEEN LARGE VESSEL AND SMALL VESSEL DISEASE IN PROF. DR. DR. MAHAR MARDJONO NATIONAL BRAIN CENTER HOSPITAL INDONESIA
Abstract
Background and Aims
Vascular Cognitive Impairment (VCI) is common after stroke. It is unclear if risk differs between ischaemic stroke subtypes. In this study, we aimed to compare the VCI feature in a large vessel disease (LVD) and small vessel disease (SVD) stroke at NBC Hospital in Indonesia.
Methods
We compared demographic and clinical data from post-stroke patients who are diagnosed with VCI based on their first comprehensive neurocognitive test (CERAD, MMSE, MOCA, Digit span, Trail Making Test (TMT)) within three months of the onset of ischemic stroke in NBC Hospital from January 2020 to December 2021. Data from localization of cerebrovascular disease and VCI were analyzed by bivariate analysis.
Results
A total of 89 patients (age 61,4±11,5 years; Male, 63%) with VCI after stroke met the inclusion criteria. Including 55 (62,5%) patients with SVD and 33 (37,5%) patients who had LVD. Cognitive domains that show impairment are the naming test (BNT), Memory (Delayed Recall), Executive Function (TMT A-B), and Visuospatial. While attention and fluency language tests remain good. There is no significant difference in the disturbing domain of cognitive impairment between the two. There was no correlation effect between the cerebrovascular lesion and the neurocognitive test, but the SVD stroke group showed more impaired TMT A-B scores.
Conclusions
Despite their small vascular size, lacunar strokes appear to be related to vascular cognitive impairment, suggesting that SVD may increase their impact more than LVD. No significant domain is involved in a small vessel and large vessel disease. More comprehensive studies on VCI with stroke subtyping are needed.