Volume 29, Issue 158, April 2025

White matter small vessel disease and vascular cognitive impairments in stroke and transient ischemic attack; systematic review

Wahab Ahmed¹, Ghazlan Ali Alhenaki², Fatima Elamin Mohammed Serour³, Salal Bader Alotaibi⁴, Sara Ali Hassan Alasiri⁵, Shahad Saleh Alsefry⁶

¹MBBS, Msc (Pharm), FMCP (Neurol), Consultant Neurologist, Neurology Department, King Khalid Hospital, Al Kharj, Saudi Arabia
²General Physician, Neurology department, First Health Cluster, Alkharj, Saudi Arabia
³Neurology Resident, Neurology Department, First Health cluster, Alkahrj Saudi Arabia
⁴General Physician, Neurology department, First Health Cluster, King Saud Medical city, Riyadh, Saudi Arabia
⁵General physician, Primary Health Care Department, Aseer Health Cluster, Abha, Saudi Arabia
⁶General physician, Emergency Medicine Department, King Faisal Medical Complex, Taif, Saudi Arabia

ABSTRACT

The purpose of this study was to ascertain if white matter abnormalities that are observed in clinical practice following stroke and TIA have an impact on neuronal function and cognitive state. We followed the PRISMA guidelines in the conduct of this study. Cochrane, PubMed, and EMBASE were extensively searched from 2017 to 2024. Studies that examined the relation between baseline WMH and dementia or cognitive impairment were included. Five papers published between 2017 and 2024 were included. Cognitive scores and the shifting WMH mean after a year of stroke are strongly correlated. Growing WMH volumes are associated with a covarying longitudinal loss of cognition and independence after a stroke, which is important for dementia diagnosis. WMH's longitudinal development is dynamic, and the regressive WMH volume was associated with regular use of antihypertensive medications. The presence of lacunes at the initial follow up to the study was a more accurate measure of WMH development. There is a strong correlation between cognition and MRI indicators of WM impairment in those who experience a TIA or minor stroke earlier in life.

Keywords: Vascular cognitive deficits, vascular dementia, stroke, transient ischemic attack, white matter hyper intensities.

Medical Science, 2025, 29, e58ms3553

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DOI: https://doi.org/10.54905/disssi.v29i158.e58ms3553

Published: 18 April 2025