Post-stroke cognitive impairment - A cross-sectional comparison study between mild cognitive impairment of vascular and non-vascular etiology

Purpose: To elucidate the cognitive profiles of post-stroke vascular mild cognitive impairment (VaMCI) in comparison to MCI of non-vascular etiology and cognitively normal healthy controls at a tertiary-care hospital in southern India. Results: Logistic regression analysis adjusted for age and sex comparing VaMCI [N = 50] with controls [N = 27] revealed significant impairment in visual, verbal learning-recall and executive function scores. As compared to the MCI group [N = 36], VaMCI had significantly higher scores on Weschler's Memory Scale (WMS) verbal subset delayed recall scores (p = 0.045, odds ratio [OR] = 2.62, 95% CI = 1.02-6.76) with lower scores on WMS-visual immediate learning scores (p = 0.042, OR = 0.35, 95% CI = 0.13-0.96), Rey Auditory Verbal Learning Test (RAVLT) total learning scores (p = 0.001, OR = 0.17, 95% CI = 0.06-0.48) and 20 minute recall (p = 0.026, OR = 0.33, 95% CI = 0.12-0.88), Delayed Matching to Sample test (DMS-48) abstract immediate (p = 0.002, OR = 0.20, 95% CI = 0.07-0.56), abstract delayed recognition sub-sets (p = 0.014, OR = 0.28, 95% CI = 0.100.78) and made more total errors on Wisconsin Card Sorting Test (WCST; p = 0.040, OR = 2.70, 95% CI = 1.05-7.14) while the MCI group significantly had more commission errors on RAVLT (p <= 0.001, OR = 0.13, 95% CI = 0.05-038) and WCST- perseverative errors (p = 0.036, OR = 030, 95% CI = 0.10-0.93). Significant differences were noted in word-list learning-recall (p = 0.012) and WMS verbal delayed recall (p = 0.014) between VaMCI with mild versus moderate to severe deep white matter hyperintensities on neuroimaging. Conclusions: Cognitive impairment following minor stroke involves episodic verbal and visual memory over and above executive function in comparison to MCI of non-vascular etiology. Close cognitive followup is warranted with adequate risk stratification and management especially in the presence of sub-cortical leukoaraiosis which is contributory to cognitive decline in this group of patients. (C) 2016 Elsevier B.V. All rights reserved.